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Chrysohoou C, Tsamadias V, Kariori M, Baroutidou A, Gerovassilis G, Akalestos A, Ziakas A, Votis K, Tsioufis K, Giannakoulas G. Evaluation of the usability of the digital platform navigator KardioUp for the journey of patients with chronic heart failure. Hellenic J Cardiol 2024; 75:32-40. [PMID: 37295668 DOI: 10.1016/j.hjc.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 03/14/2023] [Accepted: 06/02/2023] [Indexed: 06/12/2023] Open
Abstract
INTRODUCTION Digital health interventions constitute a promising supplementary approach for further improvement of the quality and experience of cardiovascular care in patients with heart failure (HF). However, concerns about privacy, security, and quality may arise additionally to lack of personal motivation and accessibility to digital resources. Therefore, the proposed system aims to implement innovative technological trends in HF monitoring by recording clinical, biological, and biometric parameters. METHODS The availability and feasibility of the digital platform KardioUp was evaluated in a group of 25 patients with HF (mean age: 60 years) and 15 medical doctors (mean age 40 years) in two University Cardiology Clinics of the country. Connectivity of platform with the application and Android devices, use of alerts in clinical measurements, educational material provided, and total satisfaction by both patients and physicians were also evaluated. Patients with health barriers to understand the use of digital platforms or low eHealth ≤8 (digital unawareness) were excluded. RESULTS All patients answered that the upload of measurements of blood pressure, blood glucose, and weight into the application were feasible. Patients mean eHealth score was 32,7. Additionally, the graphics of the application were friendly and educational material was also easily approached. Patients felt that this application can enable real patient-empowerment and self-management support. CONCLUSIONS KardioUp was evaluated as a non-pharmacological intervention that could promote autonomous living of patients. Thus, possible alterations in daily activities and other parameters will be continuously evaluated providing metrics' monitoring on patients' performance, adherence to their treatment plan, avoidance of rehospitalizations, and overall health metrics.
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Affiliation(s)
- C Chrysohoou
- National & Kapodistrian University of Athens, Athens, Greece.
| | - V Tsamadias
- Roche Diagnostics (Hellas) S.A, Marousi, Greece
| | - M Kariori
- National & Kapodistrian University of Athens, Athens, Greece
| | - A Baroutidou
- AHEPA University General Hospital, Cardiology, Thessaloniki, Greece
| | - G Gerovassilis
- Centre for Research and Technology Hellas (CERTH), Information Technologies Institute-ITI, Thessaloniki, Greece
| | - A Akalestos
- Roche Diagnostics (Hellas) S.A, Marousi, Greece
| | - A Ziakas
- AHEPA University General Hospital, Cardiology, Thessaloniki, Greece
| | - K Votis
- Centre for Research and Technology Hellas (CERTH), Information Technologies Institute-ITI, Thessaloniki, Greece
| | - K Tsioufis
- National & Kapodistrian University of Athens, Athens, Greece
| | - G Giannakoulas
- AHEPA University General Hospital, Cardiology, Thessaloniki, Greece
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Alladin A, Khawand-Azoulai M, Lipman K, Bland S, Ferrari C, Drice J, Van Zuilen MH. Analysis of Student Reflections on "What Matters Most" to Palliative Care Patients: A Narrative Medicine Exercise. J Palliat Med 2023; 26:1115-1120. [PMID: 37083420 DOI: 10.1089/jpm.2023.0032] [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: 04/22/2023] Open
Abstract
Background: Effective communication with ill patients requires practice, yet, the traditional history overlooks patients' personal stories. This information is vital to determining goals of care and facilitates partnership by building trust. Objective: We implemented a narrative medicine exercise for students during their palliative medicine rotation to highlight humanism. Impact was determined through thematic analysis of students' reflections. Design: Students elicited "what matters most" to patients, transcribing this plus a personal reflection. Using an inductive and iterative approach, 100 reflections were analyzed, developing codes then broader themes. Results: Four main themes (Getting to know the patient, Student Reaction, Building-blocks of patient-physician relationship, Student Personal Insights) were identified, with 15 subthemes. Conclusion: The power of uncovering patients' backgrounds and values was demonstrated, reinforcing a palliative medicine approach. Analysis showed a positive impact and the possibility of change to future practice. The intervention was feasible, well received, and encouraged reflection on the physician-patient relationship beyond the medical domain.
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Affiliation(s)
- Amanda Alladin
- Division of Pediatric Critical Care, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Mariana Khawand-Azoulai
- Division of Geriatrics and Palliative Medicine, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Kyra Lipman
- University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Sarah Bland
- Department of Medical Education, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Corinne Ferrari
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Jenny Drice
- Division of Geriatrics and Palliative Medicine, Department of Medical Education, University of Miami Miller School of Medicine, Miami, Florida, USA
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Wang W, Zhang J, Lu J, Wei X. Patient views of the good doctor in primary care: a qualitative study in six provinces in China. Glob Health Res Policy 2023; 8:24. [PMID: 37434267 DOI: 10.1186/s41256-023-00309-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 06/07/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND China has been striving to train primary care doctors capable of delivering high-quality service through general practitioner training programs and family doctor team reforms, but these initiatives have not adequately met patient needs and expectations. In order to guide further reform efforts to better meet patient expectations, this study generates a profile of the good doctor in primary care from the patient perspective. METHODS Semi-structured interviews were conducted in six provinces (Shandong, Zhejiang, Henan, Shaanxi, Shanxi, Heilongjiang) in China. A total of 58 interviewees completed the recorded interviews. Tape-based analysis was used to produce narrative summaries. Trained research assistants listened to the recordings of the interviews and summarized them by 30-s segments. Thematic analysis was performed on narrative summaries to identify thematic families. RESULTS Five domains and 18 attributes were generated from the analysis of the interview data. The domains of the good doctor in primary care from the patient perspective were: strong Clinical Competency (mentioned by 97% of participants) and Professionalism & Humanism (mentioned by 93% of participants) during service delivery, followed by Service Provision and Information Communication (mentioned by 74% and 62% of participants, respectively). Moreover, Chinese patients expect that primary care doctors have high educational attainment and a good personality (mentioned by 41% of participants). CONCLUSIONS This five-domain profile of the good doctor in primary care constitutes a foundation for further primary care workforce capacity building. Further primary care reform efforts should reflect the patient views and expectations, especially in the family physician competency framework and primary care performance assessment system development. Meanwhile, frontline primary care organizations also need to create supportive environments to assist competent doctors practice in primary care, especially through facilitating the learning of primary care doctors and improving their well-being.
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Affiliation(s)
- Wenhua Wang
- School of Public Policy and Administration, Xi'an Jiaotong University, No. 28 West Xianning Road, Xi'an, People's Republic of China
| | - Jinnan Zhang
- School of Public Policy and Administration, Xi'an Jiaotong University, No. 28 West Xianning Road, Xi'an, People's Republic of China
| | - Jiao Lu
- School of Public Policy and Administration, Xi'an Jiaotong University, No. 28 West Xianning Road, Xi'an, People's Republic of China
| | - Xiaolin Wei
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
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Doctor Attributes That Patients Desire during Consultation: The Perspectives of Doctors and Patients in Primary Health Care in Botswana. Healthcare (Basel) 2023; 11:healthcare11060840. [PMID: 36981497 PMCID: PMC10047964 DOI: 10.3390/healthcare11060840] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/07/2023] [Accepted: 03/10/2023] [Indexed: 03/18/2023] Open
Abstract
Doctor attributes contribute significantly to the quality of the doctor–patient relationship, consultation, patient satisfaction, and treatment outcomes. However, there is a paucity of research on this topic in many settings in developing countries, including Botswana, where accessibility and availability of care itself are a challenge. The study examined doctor attributes that patients in Botswana desire from the perspectives of doctors and patients in selected public clinics located in four health districts of Botswana. We used a qualitative design and conducted face-to-face interviews with 32 adult patients and 17 doctors selected through the purposive sampling technique. Interviews were audio-recorded and transcribed. Data analysis followed the six steps of qualitative thematic data analysis. We found both discordance and congruence between the doctors and patients on key attributes that patients desire in a doctor during consultation. Both agreed that effective communication and listening skills were key desirable doctor attributes that improve the doctor–patient relationship. Conducting the consultation in the language of the patients enhances effective communication. Doctors cited clinical expertise and competence as key desirable doctor attributes, whereas patients cited interpersonal and social attributes including kindness, empathy, and respect as key doctor attributes that increase trust in the doctor. However, patients expected the doctor to have clinical knowledge, which they perceived as essential to improve doctor–patient interaction and health outcomes. The findings highlight a need to enhance the interpersonal and communication skills of doctors to improve the quality of doctor–patient interactions. To optimise and enhance the consultation, continuing professional development should be adopted as a strategy to improve the communication and interpersonal skills of doctors.
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Simsekler MCE, Alhashmi NH, Azar E, King N, Luqman RAMA, Al Mulla A. Exploring drivers of patient satisfaction using a random forest algorithm. BMC Med Inform Decis Mak 2021; 21:157. [PMID: 33985481 PMCID: PMC8120836 DOI: 10.1186/s12911-021-01519-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 05/05/2021] [Indexed: 11/16/2022] Open
Abstract
Background Patient satisfaction is a multi-dimensional concept that provides insights into various quality aspects in healthcare. Although earlier studies identified a range of patient and provider-related determinants, their relative importance to patient satisfaction remains unclear. Methods We used a tree-based machine-learning algorithm, random forests, to estimate relationships between patient and provider-related determinants and satisfaction level in two of the main patient journey stages, registration and consultation, through survey data from 411 patients at a hospital in Abu Dhabi, UAE. Radar charts were also generated to determine which type of questions—demographics, time, behaviour, and procedure—influence patient satisfaction. Results Our results showed that the ‘age’ attribute, a patient-related determinant, is the leading driver of patient satisfaction in both stages. ‘Total time taken for registration’ and ‘attentiveness and knowledge of the doctor/physician while listening to your queries’ are the leading provider-related determinants in each model developed for registration and consultation stages, respectively. The radar charts revealed that ‘demographics’ are the most influential type in the registration stage, whereas ‘behaviour’ is the most influential in the consultation stage. Conclusions Generating valuable results, the random forest model provides significant insights on the relative importance of different determinants to overall patient satisfaction. Healthcare practitioners, managers and researchers can benefit from applying the model for prediction and feature importance analysis in their particular healthcare settings and areas of their concern.
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Affiliation(s)
- Mecit Can Emre Simsekler
- Department of Industrial and Systems Engineering, Khalifa University of Science and Technology, P.O. Box 127788, Abu Dhabi, UAE.
| | - Noura Hamed Alhashmi
- Department of Industrial and Systems Engineering, Khalifa University of Science and Technology, P.O. Box 127788, Abu Dhabi, UAE
| | - Elie Azar
- Department of Industrial and Systems Engineering, Khalifa University of Science and Technology, P.O. Box 127788, Abu Dhabi, UAE
| | - Nelson King
- Department of Industrial and Systems Engineering, Khalifa University of Science and Technology, P.O. Box 127788, Abu Dhabi, UAE
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Fan X, Su M, Zhao Y, Wang D. Dissatisfaction with Local Medical Services for Middle-Aged and Elderly in China: What Is Relevant? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18083931. [PMID: 33918074 PMCID: PMC8069492 DOI: 10.3390/ijerph18083931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/04/2021] [Accepted: 04/07/2021] [Indexed: 11/16/2022]
Abstract
As violent clashes between doctors and patients in China intensify, patient dissatisfaction has been identified as a major concern in the current healthcare reform in China. This study aims to investigate the main determinants of dissatisfaction with local medical services attributable to middle-aged and elderly characteristics and identify areas for improvement. A total of 14,263 rural participants and 4898 urban participants were drawn from the China Health and Retirement Longitudinal Study in 2018. Dissatisfaction was measured by two methods: binary outcome (1 = Dissatisfaction; 0 = No) demonstrated the risk of occurring dissatisfaction among various characteristics, and continuous outcome (ranges from score 1 to 5) showed the degree. The mean score of dissatisfaction was 2.73 ± 1.08. Sixteen percent of rural participants and 19% of urban participants reported dissatisfaction with local medical services, respectively. The multilevel analyses demonstrated that participants' utilization of paid family doctor services decreased the risk of occurring dissatisfaction; dissatisfaction was less focused on females; having chronic diseases increased the risk of dissatisfaction. This study suggests promotion of family doctor services can effectively reduce middle-aged and elderly dissatisfaction with the local medical services. In addition, more attention should be focused on males and middle-aged and elderly with chronic diseases in order to decrease dissatisfaction.
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Affiliation(s)
- Xiaojing Fan
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an 710049, China;
| | - Min Su
- School of Public Administration, Inner Mongolia University, Hohhot 010021, China
- Correspondence: ; Tel.: +86-131-9051-0058
| | - Yaxin Zhao
- School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China;
| | - Duolao Wang
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK;
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McGraw C, Pekarek J, Redmond D, Vogel R, Tanner A, Bar-Or D. Is preexisting mental illness associated with lower patient satisfaction for older trauma patients? A cross-sectional descriptive study. BMC Psychiatry 2021; 21:67. [PMID: 33516194 PMCID: PMC7847564 DOI: 10.1186/s12888-021-03071-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 01/25/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study was to examine if satisfaction with care differs among older trauma patients with and without preexisting mental illness (PMI+/PMI-). METHODS Data from two level I trauma centers were examined from 11/2016 through 12/2017. Trauma patients ≥55 years were included and satisfaction of those who had a diagnosis of mental illness prior to the trauma admission (PMI+) to those without a diagnosis (PMI-) (n = 299; 62 PMI+ and 237 PMI-) were compared. Enrolled patients completed the Family Satisfaction with Advanced Care Cancer Scale Patient Survey (FAMCARE-P13) prior to discharge. Associations between mental illness status and patient baseline characteristics, overall mean satisfaction, and mean satisfaction by question were compared. Generalized linear models adjusted for differences in patient satisfaction by mental illness status. Analyses were stratified by hospital to account for the interaction between hospital and mental illness status. RESULTS Compared to PMI- patients, PMI+ patients were more likely to be younger, female, have multiple comorbidities, and to report lower overall satisfaction with care. Among PMI+ patients, the most common diagnoses were depression and anxiety. After adjustment, PMI+ was associated with lower patient satisfaction at hospital 1; after examining individual questions lower satisfaction was associated with information provided on procedures and questions surrounding "Physical care." Conversely, PMI+ did not affect satisfaction at hospital 2 after adjustment. CONCLUSIONS At hospital 1, room for improvement was identified in providing information about prognosis and procedures, symptom management, and continuity of care. Reexamining practices for older PMI+ trauma patients is warranted.
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Affiliation(s)
- Constance McGraw
- Trauma Research Department, St. Anthony Hospital, CO, Lakewood, USA
- Trauma Research Department, Penrose-St. Francis Health Services, Colorado Springs, CO, USA
| | - Jennifer Pekarek
- Trauma Research Department, St. Anthony Hospital, CO, Lakewood, USA
| | - Diane Redmond
- Trauma Research Department, Penrose-St. Francis Health Services, Colorado Springs, CO, USA
| | - Rebecca Vogel
- Trauma Services Department, St. Anthony Hospital, Lakewood, CO, USA
| | - Allen Tanner
- Trauma Services Department, Penrose St.-Francis Health Services, Colorado Springs, CO, USA
| | - David Bar-Or
- Trauma Research Department, St. Anthony Hospital, CO, Lakewood, USA.
- Trauma Research Department, Penrose-St. Francis Health Services, Colorado Springs, CO, USA.
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Vogel R, McGraw C, Orlando A, Bourg P, Dreiman C, Peck L, Tanner A, Lynch N, Bar-Or D. Examining satisfaction of older adult patients and their caregivers following traumatic injury: a cross-sectional study of three level I trauma centres. BMJ Open 2019; 9:e032374. [PMID: 31719090 PMCID: PMC6858218 DOI: 10.1136/bmjopen-2019-032374] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To explore satisfaction of care received by older adult patients and their primary caregivers following traumatic injury. DESIGN Prospective, cross-sectional study using the FAMCARE (Family Satisfaction with Advanced Cancer Care Scale) satisfaction surveys prior to discharge. SETTING Three level I trauma centres in Colorado from November 2016 to December 2017. PARTICIPANTS Trauma patients ≥55 years old and their primary caregivers. OUTCOME MEASURES Overall mean (SD) satisfaction, satisfaction <80% vs ≥80%, and mean satisfaction by survey conceptual structures. RESULTS Of the 319 patients and 336 caregivers included, the overall mean (SD) patient satisfaction was 81.7% (15.0%) and for caregivers was 83.6% (13.4%). The area with the highest mean for patient and caregiver satisfaction was psychosocial care (85.4% and 86.9%, respectively). Information giving was the lowest for patients (80.4%) and caregivers (80.9%). When individual items were examined, patients were significantly more satisfied with 'availability of nurses to answer questions' (84.5 (15.3) vs 87.4 (14.8), p=0.02) and significantly less satisfied with 'speed with which symptoms were treated' (80.6 (17.9) vs 84.0 (17.0), p=0.03) compared with caregivers. Patients with a history of smoking (least squares mean difference: -0.096 (-0.18 to -0.07), p<0.001) and hospital discharge destination to an outside facility of care (adjusted OR: 1.6 (1.0 to 2.4), p=0.048) were identified as independent predictors of lower overall satisfaction in generalised linear and logistic models, respectively. CONCLUSIONS Our data suggest that patients' medical history was driving both patient and caregiver satisfaction. Patient characteristics and expectations need to be considered when tailoring healthcare interventions.
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Affiliation(s)
- Rebecca Vogel
- Trauma Services Department, St. Anthony's Hospital, Lakewood, Colorado, USA
| | - Constance McGraw
- Trauma Research Department, St Anthony Hospital, Lakewood, Colorado, USA
- Trauma Research Department, Swedish Medical Center, Englewood, Colorado, USA
- Trauma Research Department, Penrose Hospital, Colorado Springs, Colorado, USA
| | - Alessandro Orlando
- Trauma Research Department, St Anthony Hospital, Lakewood, Colorado, USA
- Trauma Research Department, Swedish Medical Center, Englewood, Colorado, USA
- Trauma Research Department, Penrose Hospital, Colorado Springs, Colorado, USA
| | - Pamela Bourg
- Trauma Services Department, St. Anthony's Hospital, Lakewood, Colorado, USA
| | - Chester Dreiman
- Trauma Services Department, St. Anthony's Hospital, Lakewood, Colorado, USA
| | - Laura Peck
- Trauma Services Department, Swedish Medical Center, Englewood, Colorado, USA
| | - Allen Tanner
- Trauma Services Department, Penrose Hospital, Colorado Springs, Colorado, USA
| | - Neal Lynch
- Trauma Services Department, Penrose Hospital, Colorado Springs, Colorado, USA
| | - David Bar-Or
- Trauma Research Department, St Anthony Hospital, Lakewood, Colorado, USA
- Trauma Research Department, Swedish Medical Center, Englewood, Colorado, USA
- Trauma Research Department, Penrose Hospital, Colorado Springs, Colorado, USA
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Gavina V, Alves N, Alves F, Cortellazzi K, Silveira F, Assaf A. Oral Health for Patients with Special Needs: Evaluative Research of the Dental Specialties Centers. PORTUGUESE JOURNAL OF PUBLIC HEALTH 2018. [DOI: 10.1159/000493886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Analyzing Relationship between Patient and Doctor in Public Dental Health using Particle Memetic Multivariable Logistic Regression Analysis Approach (MLRA2). J Med Syst 2018; 42:183. [PMID: 30155746 DOI: 10.1007/s10916-018-1037-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 08/20/2018] [Indexed: 10/28/2022]
Abstract
In the developing technology managing patient and doctor relationship and communication process is one of the critical factors because the patient may take high risk surgery, treatment and diagnosis. Due to the importance of the patient-doctor relationship, in this paper investigate the various aspects of relation between the doctor and dental problem related patients. During the analyzing process, data has been collected from adults who are facing dental problems and other dental injuries in which data has been gathered from 423 individuals by conducting interviews. The gathered data is investigated with the help of particle-memetic multivariable logistic regression analysis method which examines the patient income, dental surgical details, injuries and other factors relationship has been investigated. From the analyzed data, how the patients are treated by doctors examined for improving the relationship between patient and doctor in public dental health aspects.
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Inpatient satisfaction with medical information received from caregivers: an observational study on the effect of social deprivation. BMC Health Serv Res 2017; 17:769. [PMID: 29169348 PMCID: PMC5701506 DOI: 10.1186/s12913-017-2728-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Accepted: 11/14/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The main objective of this study was to explore the relationships between inpatients' social differentiation and satisfaction with the medical information delivered by caregivers. METHODS In four departments of a teaching hospital, patients were enrolled as well as their attending physician and one of the nurses assigned to them. Structured survey questionnaires were administered face-to-face to patients and caregivers. Patients were asked to rate their satisfaction with the medical information received, the quality and duration of the interactions with the caregivers, and their experience regarding their involvement in medical decision-making. Caregivers were asked to rate their perception of the patients' social position and involvement in medical decision-making. Social deprivation was assessed using the EPICES score in particular. The statistical analysis was mainly descriptive and completed by a structural equation model. RESULTS A sample of 255 patients, 221 pairs of patient-physician and 235 pairs of patient-nurse were considered. One third of the patients (32.7%) were identified as socially deprived. They were significantly less satisfied with the information they received on their health status or their treatment; 56.7% of patients thought that they received sufficient explanations without having to ask. This proportion was significantly lower in socially deprived patients (42.3%) compared to not deprived patients (63.6%, p < 0.01). Patients' reported involvement in medical decision-making was significantly lower for socially deprived patients (75.0% vs 89.0%, p < 0.001). The structural equation model showed that the main determinant of patients' satisfaction regarding medical information was their perceived involvement in informed medical decision-making (CFI = 0.998, RMSEA = 0.022). CONCLUSIONS These findings suggest that physicians and nurses need training on communication targeted towards vulnerable patients, in order to improve the accessibility of medical information, and thus to reduce health inequalities.
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Smith-Carrier T, Sinha SK, Nowaczynski M, Akhtar S, Seddon G, Pham TNT. It 'makes you feel more like a person than a patient': patients' experiences receiving home-based primary care (HBPC) in Ontario, Canada. HEALTH & SOCIAL CARE IN THE COMMUNITY 2017; 25:723-733. [PMID: 27287281 DOI: 10.1111/hsc.12362] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/28/2016] [Indexed: 06/06/2023]
Abstract
The lack of effective systems to appropriately manage the health and social care of frail older adults - especially among those who become homebound - is becoming all the more apparent. Home-based primary care (HBPC) is increasingly being promoted as a promising model that takes into account the accessibility needs of frail older adults, ensuring that they receive more appropriate primary and community care. There remains a paucity of literature exploring patients' experiences with HBPC programmes. The purpose of this study was to explore the experiences of patients accessing HBPC delivered by interprofessional teams, and their perspectives on the facilitators and barriers to this model of care in Ontario, Canada. Using certain grounded theory principles, we conducted an inductive qualitative content analysis of in-depth patient interviews (n = 26) undertaken in the winter of 2013 across seven programme sites exploring the lived experiences and perspectives of participants receiving HBPC. Themes emerged in relation to patients' perceptions regarding the preference for and necessity of HBPC, the promotion of better patient care afforded by the model in comparison to office-based care, and the benefits of and barriers to HBPC service provision. Underlying patterns also surfaced related to patients' feelings and emotions about their quality of life and satisfaction with HBPC services. We argue that HBPC is well positioned to serve frail homebound older adults, ensuring that patients receive appropriate primary and community care - which the office-based alternative provides little guarantee - and that they will be cared for, pointing to a model that may not only lead to greater patient satisfaction but also likely contributes to bettering the quality of life of a highly vulnerable population.
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Affiliation(s)
- Tracy Smith-Carrier
- School of Social Work, King's University College at Western University, London, Ontario, Canada
| | - Samir K Sinha
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Johns Hopkins University School of Medicine, Balitmore, Maryland, USA
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Mark Nowaczynski
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- House Calls: Interdisciplinary Healthcare for Homebound Seniors, SPRINT Senior Care, Toronto, Ontario, Canada
| | - Sabrina Akhtar
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- Home-Based Care Program, Toronto Western Family Health Team, Toronto, Ontario, Canada
| | - Gayle Seddon
- Toronto Central Community Care Access Centre, Toronto, Ontario, Canada
| | - Thuy-Nga Tia Pham
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- South East Toronto Family Health Team, Toronto, Ontario, Canada
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Jalil A, Zakar R, Zakar MZ, Fischer F. Patient satisfaction with doctor-patient interactions: a mixed methods study among diabetes mellitus patients in Pakistan. BMC Health Serv Res 2017; 17:155. [PMID: 28222721 PMCID: PMC5320691 DOI: 10.1186/s12913-017-2094-6] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 02/11/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patient satisfaction with doctor-patient interactions is an indicator of physicians' competence. The satisfaction of diabetes patients is rarely studied in public diabetes clinics of Pakistan. Thus, this study aims to analyse the association between patient satisfaction and five dimensions of medical interaction: technical expertise, interpersonal aspects, communication, consultation time, and access/availability. METHODS A cross-sectional mixed methods study was conducted during July and August 2015 in the largest public diabetes outpatient clinic in Punjab province. We used the criterion sampling method to identify 1164 patients who: (i) were adult (18 years and above), (ii) had diabetes mellitus, (iii) had made at least three previous visits to the same clinic. The data was collected through face-to-face interviews. The structured part of the questionnaire was based on demographic characteristics and the Patient Satisfaction Questionnaire (PSQ-III). We translated the questionnaire into Urdu and pretested it with 25 patients in a similar context. Data storage and analysis were carried out using SPSS (version 22.0). Bivariate analyses and multinomial logistic regression model were used to generate the quantitative findings. Out of the 1164 eligible patients approached for interviews, 1095 patients completed the structured questionnaire and 186 respondents provided qualitative information in comments section. We conducted a thematic content analysis of qualitative responses in order to explain the quantitative findings. RESULTS Demographic characteristics such as gender, education and occupation were significantly associated with the levels of patient satisfaction. The dimensions of doctor-patient interaction were significantly associated with patient satisfaction: technical expertise (OR = .87; 95% CI = .84-.91), interpersonal aspects (OR = .82; 95% CI = .77-.87), communication (OR = .83; 95% CI = .78-.89), time dimension (OR = .90; 95% CI = .81-.99) and access/availability (OR = .78; 95% CI = .72-.84). Several factors involving doctors' incompetence, such as inappropriate handling of critical cases, inaccurate diagnose, excessive reliance on medical tests, absence of physical examination, non-availability of specialist doctors, and experimentation by trainee doctors were related to patient dissatisfaction. CONCLUSION The findings of this study highlight a need to develop the interpersonal and clinical skills of doctors in order to improve the quality of doctor-patient interactions in public clinics for diabetes in Pakistan. Prospective researches should explore context-specific factors that form patient satisfaction.
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Affiliation(s)
- Aisha Jalil
- Department of Sociology, Institute of Social and Cultural Studies, University of the Punjab, Lahore, Pakistan
| | - Rubeena Zakar
- Department of Public Health, Institute of Social and Cultural Studies, University of the Punjab, Lahore, Pakistan
| | - Muhammad Zakria Zakar
- Institute of Social and Cultural Studies, University of the Punjab, Lahore, Pakistan
| | - Florian Fischer
- Department of Public Health Medicine, School of Public Health, Bielefeld University, Bielefeld, Germany.
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Azami-Aghdash S, Tabrizi JS, Mohseni M, Naghavi-Behzad M, Daemi A, Saadati M. Nine years of publications on strengths and weaknesses of Family Physician Program in rural area of Iran: A systematic review. JOURNAL OF ANALYTICAL RESEARCH IN CLINICAL MEDICINE 2016. [DOI: 10.15171/jarcm.2016.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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15
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Brooks SK, Gerada C, Chalder T. The specific needs of doctors with mental health problems: qualitative analysis of doctor-patients' experiences with the Practitioner Health Programme. J Ment Health 2016; 26:161-166. [PMID: 27841030 DOI: 10.1080/09638237.2016.1244712] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The current paper aimed to explore doctor-patients' views about their treatment from the Practitioner Health Programme (PHP), a UK-based service treating health professionals with mental health/addiction problems. Aims were to gain insights into the issues most important to patients and consider whether a service specifically for doctors is important in helping to overcome barriers to accessing mental healthcare. METHODS Nine doctor-patients attending PHP took part in semi-structured interviews between September 2010 and June 2011. Thematic analysis was used to explore recurring patterns in the data. 134 written comments from PHP patients were also included. RESULTS Participants reported difficulties in finding appropriate treatment; problems were often severe by the time PHP was involved. Concerns about confidentiality, judgement and impact on career were obstacles to help-seeking and important issues during treatment. Analysis of written comments provided further support for these findings. CONCLUSION Whilst some of the needs of mentally unwell doctors mirror the needs of patients in general - e.g. a supportive and non-judgemental attitude from clinicians - they do have specific needs related to confidentiality and stigma.
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Affiliation(s)
- Samantha K Brooks
- a Department of Psychological Medicine , King's College London, Institute of Psychiatry, Weston Education Centre , London , UK , and
| | - Clare Gerada
- b Practitioner Health Programme, Riverside Medical Centre , Vauxhall , London , UK
| | - Trudie Chalder
- a Department of Psychological Medicine , King's College London, Institute of Psychiatry, Weston Education Centre , London , UK , and
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16
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Opondo C, Allen E, Todd J, English M. The Paediatric Admission Quality of Care (PAQC) score: designing a tool to measure the quality of early inpatient paediatric care in a low-income setting. Trop Med Int Health 2016; 21:1334-1345. [PMID: 27391580 PMCID: PMC5053245 DOI: 10.1111/tmi.12752] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Background Evaluating clinician compliance with recommended steps in clinical guidelines provides one measure of quality of process of care but can result in a multiplicity of indicators across illnesses, making it problematic to produce any summative picture of process quality, information that may be most useful to policy‐makers and managers. Objective We set out to develop a clinically logical summative measure of the quality of care provided to children admitted to hospital in Kenya spanning the three diagnoses present in 60% or more of admissions that would provide a patient‐level measure of quality of care in the face of comorbidity. Methods We developed a conceptual model of care based on three domains: assessment, diagnosis and treatment of illnesses. Individual items within domains correspond to recommended processes of care within national clinical practice guidelines. Summative scores were created to reduce redundancy and enable aggregation across illnesses while maintaining a clear link to clinical domains and our conceptual model. The potential application of the score was explored using data from more than 12 000 children from eight hospitals included in a prior intervention study in Kenya. Results Summative scores obtained from items representing discrete clinical decision points reduced redundancy, aided balance of score contribution across domains and enabled direct comparison of disease‐specific scores and the calculation of scores for children with comorbidity. Conclusion This work describes the development of a summative Paediatric Admission Quality of Care score measured at the patient level that spans three common diseases. The score may be an efficient tool for assessing quality with an ability to adjust for case mix or other patient‐level factors if needed. The score principles may have applicability to multiple illnesses and settings. Future analysis will be needed to validate the score.
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Affiliation(s)
- Charles Opondo
- Health Services Unit, KEMRI Wellcome Trust Research Programme, Nairobi, Kenya. .,Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK.
| | - Elizabeth Allen
- Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK
| | - Jim Todd
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK.,Department of Epidemiology and Biostatistics, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Mike English
- Health Services Unit, KEMRI Wellcome Trust Research Programme, Nairobi, Kenya.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
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Batbaatar E, Dorjdagva J, Luvsannyam A, Savino MM, Amenta P. Determinants of patient satisfaction: a systematic review. Perspect Public Health 2016; 137:89-101. [PMID: 27004489 DOI: 10.1177/1757913916634136] [Citation(s) in RCA: 355] [Impact Index Per Article: 44.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
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.
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Affiliation(s)
- Enkhjargal Batbaatar
- Department of Health Policy and Management, School of Public Health, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia; Faculty of Economy and Business Sciences, University of Sannio, Benevento, Italy
| | - Javkhlanbayar Dorjdagva
- Department of Health Policy and Management, School of Public Health, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia; The Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Ariunbat Luvsannyam
- Department of Business Management, Ulaanbaatar University, Ulaanbaatar, Mongolia
| | | | - Pietro Amenta
- Faculty of Economy and Business Sciences, University of Sannio, Benevento, Italy
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Rubenstein J, Zettel JC, Lee E, Cote M, Aziza A, Connolly BL. Pediatric interventional radiology clinic - how are we doing? Pediatr Radiol 2016; 46:1165-72. [PMID: 27053279 DOI: 10.1007/s00247-016-3593-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 12/06/2015] [Accepted: 02/19/2016] [Indexed: 11/24/2022]
Abstract
BACKGROUND Development of a pediatric interventional radiology clinic is a necessary component of providing a pediatric interventional radiology service. Patient satisfaction is important when providing efficient, high-quality care. OBJECTIVE To analyze the care provided by a pediatric interventional radiology clinic from the perspective of efficiency and parent satisfaction, so as to identify areas for improvement. MATERIALS AND METHODS The prospective study was both quantitative and qualitative. The quantitative component measured clinic efficiency (waiting times, duration of clinic visit, nurse/physician time allocation and assessments performed; n = 91). The qualitative component assessed parental satisfaction with their experience with the pediatric interventional radiology clinic, using a questionnaire (5-point Likert scale) and optional free text section for feedback (n = 80). Questions explored the family's perception of relevance of information provided, consent process and overall satisfaction with their pediatric interventional radiology clinic experience. RESULTS Families waited a mean of 11 and 10 min to meet the physician and nurse, respectively. Nurses and physicians spent a mean of 28 and 21 min with the families, respectively. The average duration of the pediatric interventional radiology clinic consultation was 56 min. Of 80 survey participants, 83% were satisfied with their experience and 94% said they believed providing consent before the day of the procedure was helpful. Only 5% of respondents were not satisfied with the time-efficiency of the interventional radiology clinic. CONCLUSION Results show the majority of patients/parents are very satisfied with the pediatric interventional radiology clinic visit. The efficiency of the pediatric interventional radiology clinic is satisfactory; however, adherence to stricter scheduling can be improved.
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Affiliation(s)
- Jonathan Rubenstein
- Image Guided Therapy, Diagnostic Imaging, The Hospital for Sick Children & University of Toronto, 555 University Ave., Toronto, ON, M5G 1X8, Canada.,York University, Toronto, ON, Canada
| | - Julie C Zettel
- Image Guided Therapy, Diagnostic Imaging, The Hospital for Sick Children & University of Toronto, 555 University Ave., Toronto, ON, M5G 1X8, Canada
| | - Eric Lee
- Image Guided Therapy, Diagnostic Imaging, The Hospital for Sick Children & University of Toronto, 555 University Ave., Toronto, ON, M5G 1X8, Canada
| | - Michelle Cote
- Image Guided Therapy, Diagnostic Imaging, The Hospital for Sick Children & University of Toronto, 555 University Ave., Toronto, ON, M5G 1X8, Canada
| | - Albert Aziza
- Image Guided Therapy, Diagnostic Imaging, The Hospital for Sick Children & University of Toronto, 555 University Ave., Toronto, ON, M5G 1X8, Canada
| | - Bairbre L Connolly
- Image Guided Therapy, Diagnostic Imaging, The Hospital for Sick Children & University of Toronto, 555 University Ave., Toronto, ON, M5G 1X8, Canada.
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Kabatooro A, Ndoboli F, Namatovu J. Patient satisfaction with medical consultations among adults attending Mulago hospital assessment centre. S Afr Fam Pract (2004) 2016; 58:87-93. [PMID: 28480060 PMCID: PMC5417694 DOI: 10.1080/20786190.2016.1177977] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background Patient satisfaction is known to positively influence patients’ compliance with medical advice. In Africa, and specifically Uganda, this interaction has rarely been put to scientific inquiry. This study aimed to determine the level of patient satisfaction and identify factors influencing satisfaction with medical consultations among adults attending Mulago Assessment Centre. Methods This was a quantitative descriptive cross-sectional study where 384 respondents were interviewed using a structured questionnaire adapted from the Medical Interview Satisfaction Scale (MISS-21) with a four-point Likert scale. Patient satisfaction was measured using four dimensions namely: information provision, clinicians’ communication skills, perceived consulting time and patient’s confidence in the clinician. Respondents’ mean scores were categorised as satisfied or dissatisfied. Multivariate linear regression analysis assessed the effect of independent variables on the regression factor score of the dependent variable. Significance level was set at p < 0.05. Final data analysis was done using STATA version 11.0. Results Of the sample, 53.9% were satisfied with the medical consultation. Patients’ average scores showed lowest satisfaction for information provision (2.7 points) compared with communication skills (3.22 points), patient confidence in the clinicians (3.22 points) and consultation time (3.05 points). Being older, employed, living further away from the health centre and frequently visiting the centre were positively associated with patient satisfaction. Conclusions Patient satisfaction was largely affected by interpersonal factors. This highlights the need for training of clinicians on the importance of adequate information provision, good communication skills and technical competences like thorough examination of patients and relieving worries about illness during the consultation.
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Affiliation(s)
- Angella Kabatooro
- Department of Family Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Fred Ndoboli
- Department of Family Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Jane Namatovu
- Department of Family Medicine, Makerere University College of Health Sciences, Kampala, Uganda
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Boquiren VM, Hack TF, Beaver K, Williamson S. What do measures of patient satisfaction with the doctor tell us? PATIENT EDUCATION AND COUNSELING 2015; 98:S0738-3991(15)00264-5. [PMID: 26111500 DOI: 10.1016/j.pec.2015.05.020] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2014] [Revised: 05/28/2015] [Accepted: 05/30/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To gain an understanding of how patient satisfaction (PS) with the doctor (PSD) is conceptualized through an empirical review of how it is currently being measured. The content of PS questionnaire items was examined to (a) determine the primary domains underlying PSD, and (b) summarize the specific doctor-related characteristics and behaviors, and patient-related perceptions, composing each domain. METHODS A scoping review of empirical articles that assessed PSD published from 2000 to November 2013. MEDLINE and PsycINFO databases were searched. RESULTS The literature search yielded 1726 articles, 316 of which fulfilled study inclusion criteria. PSD was realized in one of four health contexts, with questions being embedded in a larger questionnaire that assessed PS with either: (1) overall healthcare, (2) a specific medical encounter, or (3) the healthcare team. In the fourth context, PSD was the questionnaire's sole focus. Five broad domains underlying PSD were revealed: (1) Communication Attributes; (2) Relational Conduct; (3) Technical Skill/Knowledge; (4) Personal Qualities; and (5) Availability/Accessibility. CONCLUSIONS Careful consideration of measurement goals and purposes is necessary when selecting a PSD measure. PRACTICE IMPLICATIONS The five emergent domains underlying PSD point to potential key areas of physician training and foci for quality assessment.
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Affiliation(s)
- Virginia M Boquiren
- Behavioural Sciences & Health Research Division, University Health Network, Toronto, Ontario, Canada; College of Nursing, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
| | - Thomas F Hack
- College of Nursing, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada; School of Health, University of Central Lancashire, Preston, UK.
| | - Kinta Beaver
- School of Health, University of Central Lancashire, Preston, UK.
| | - Susan Williamson
- School of Health, University of Central Lancashire, Preston, UK.
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Leininger BD, Evans R, Bronfort G. Exploring patient satisfaction: a secondary analysis of a randomized clinical trial of spinal manipulation, home exercise, and medication for acute and subacute neck pain. J Manipulative Physiol Ther 2014; 37:593-601. [PMID: 25199824 PMCID: PMC4186899 DOI: 10.1016/j.jmpt.2014.08.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 07/01/2014] [Accepted: 07/08/2014] [Indexed: 01/06/2023]
Abstract
OBJECTIVE The purpose of this study was to assess satisfaction with specific aspects of care for acute neck pain and explore the relationship between satisfaction with care, neck pain, and global satisfaction. METHODS This study was a secondary analysis of patient satisfaction from a randomized trial of spinal manipulation therapy (SMT) delivered by doctors of chiropractic, home exercise and advice (HEA) delivered by exercise therapists, and medication (MED) prescribed by a medical doctors for acute/subacute neck pain. Differences in satisfaction with specific aspects of care were analyzed using a linear mixed model. The relationship between specific aspects of care and (1) change in neck pain (primary outcome of the randomized trial) and (2) global satisfaction were assessed using Pearson's correlation and multiple linear regression. RESULTS Individuals receiving SMT or HEA were more satisfied with the information and general care received than MED group participants. Spinal manipulation therapy and HEA groups reported similar satisfaction with information provided during treatment; however, the SMT group was more satisfied with general care. Satisfaction with general care (r = -0.75 to -0.77; R(2) = 0.55-0.56) had a stronger relationship with global satisfaction compared with satisfaction with information provided (r = -0.65 to 0.67; R(2) = 0.39-0.46). The relationship between satisfaction with care and neck pain was weak (r = 0.17-0.38; R(2) = 0.08-0.21). CONCLUSIONS Individuals with acute/subacute neck pain were more satisfied with specific aspects of care received during spinal manipulation therapy or home exercise interventions compared to receiving medication. The relationship between neck pain and satisfaction with care was weak.
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Affiliation(s)
- Brent D Leininger
- Research Fellow, Integrative Health & Wellbeing Research Program, Center for Spirituality & Healing, University of Minnesota, Minneapolis, MN.
| | - Roni Evans
- Associate Professor, Integrative Health & Wellbeing Research Program, Center for Spirituality & Healing, University of Minnesota, Minneapolis, MN
| | - Gert Bronfort
- Professor, Integrative Health & Wellbeing Research Program, Center for Spirituality & Healing, University of Minnesota, Minneapolis, MN
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Patients do not always complain when they are dissatisfied: implications for service quality and patient safety. J Patient Saf 2014; 9:224-31. [PMID: 24257066 DOI: 10.1097/pts.0b013e3182913837] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This study aimed to explore the actions taken by patients who had been admitted to an acute care Queensland hospital and experienced dissatisfaction with service delivery. It is proposed that before complaints can be used as part of a strategy to inform health service improvement and ultimately ensure patient safety, an understanding of the effectiveness of the complaints handling process from the patient's perspective must be gained. METHODS In-depth qualitative interviews using a phenomenological exploration were undertaken. The theoretical framework supporting the thematic analysis of the interview data was drawn from Lazarus's cognitive emotive model of coping. Analysis of the research data, aided by Leximancer software, revealed a series of relational themes that supported the interpretative data analysis process undertaken. FINDINGS In 16 interviews, the study outcomes identified that 15 of the participants did not voice their complaint at the time of the event, but after the event, they stated they wished that they had reacted differently and complained at the actual point in time that they were dissatisfied. The themes that emerged that reflected potential lost opportunities included issues with ineffective communication, being treated with disrespect, inconsistent standards of care, perceptions of negligence, and lack of information about how to make a complaint. CONCLUSIONS Our findings suggest that health-care professionals should take a more active role in identifying and responding to patients who are experiencing dissatisfaction but are not actively complaining. This level of vigilance and responsiveness will ensure opportunities to improve health service delivery, and patient safety are not lost.
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Palmer SC, de Berardis G, Craig JC, Tong A, Tonelli M, Pellegrini F, Ruospo M, Hegbrant J, Wollheim C, Celia E, Gelfman R, Ferrari JN, Törok M, Murgo M, Leal M, Bednarek-Skublewska A, Dulawa J, Strippoli GFM. Patient satisfaction with in-centre haemodialysis care: an international survey. BMJ Open 2014; 4:e005020. [PMID: 24840250 PMCID: PMC4039823 DOI: 10.1136/bmjopen-2014-005020] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES To evaluate patient experiences of specific aspects of haemodialysis care across several countries. DESIGN Cross-sectional survey using the Choices for Healthy Outcomes in Caring for End-Stage Renal Disease (CHOICE) questionnaire. SETTING Haemodialysis clinics within a single provider in Europe and South America. PARTICIPANTS 2748 adults treated in haemodialysis. PRIMARY AND SECONDARY OUTCOMES The primary outcome was patient satisfaction with overall care. Secondary outcomes included patient experiences of individual aspects of dialysis care. RESULTS 2145 (78.1%) adults responded to the questionnaire. Fewer than half (46.5% (95% CI 44.5% to 48.6%)) rated their overall care as excellent. Global perceptions of care were uninfluenced by most respondent characteristics except age and depressive symptoms; older respondents were less critical of their care (adjusted OR for excellent rating 1.44 (1.01 to 2.04)) and those with depressive symptoms were less satisfied (0.56 (0.44 to 0.71)). Aspects of care that respondents most frequently ranked as excellent were staff attention to dialysis vascular access (54% (52% to 56%)); caring of nurses (53% (51% to 55%)); staff responsiveness to pain or discomfort (51% (49% to 53%)); caring, helpfulness and sensitivity of dialysis staff (50% (48% to 52%)); and ease of reaching dialysis staff by telephone (48% (46% to 50%)). The aspects of care least frequently ranked as excellent were information provided when choosing a dialysis modality (23% (21% to 25%)), ease of seeing a social worker (28% (24% to 32%)), information provided about dialysis (34% (32% to 36%)), accuracy of information from nephrologist (eg, about prognosis or likelihood of a kidney transplant; 37% (35% to 39%)) and accuracy of nephrologists' instructions (39% (36% to 41%)). CONCLUSIONS Haemodialysis patients are least satisfied with the complex aspects of care. Patients' expectations for accurate information, prognosis, the likelihood of kidney transplantation and their options when choosing dialysis treatment need to be considered when planning healthcare research and practices.
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Affiliation(s)
- Suetonia C Palmer
- Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand
| | | | - Jonathan C Craig
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Allison Tong
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Marcello Tonelli
- Division of Nephrology and Immunology, University of Alberta, Edmonton, Canada
| | - Fabio Pellegrini
- Consorzio Mario Negri Sud, S. Maria Imbaro, Italy
- Scientific Institute Casa Sollievo della Sofferenza, Italy
| | | | | | | | | | | | | | | | - Marco Murgo
- Diaverum Scientific Medical Office, Lund, Sweden
| | - Miguel Leal
- Diaverum Scientific Medical Office, Lund, Sweden
| | | | - Jan Dulawa
- Diaverum Scientific Medical Office, Lund, Sweden
| | - Giovanni F M Strippoli
- Consorzio Mario Negri Sud, S. Maria Imbaro, Italy
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
- Diaverum Scientific Medical Office, Lund, Sweden
- Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
- Division of Nephrology and Transplantation, Department of Translational Medicine,Amedeo Avogadro University of Eastern Piedmont, Novara, Italy
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Rivera ME, Hexem KR, Womer JW, Vinelli E, Feudtner C. Parents' satisfaction with repair of paediatric cleft lip/cleft palate in Honduras. Paediatr Int Child Health 2013; 33:170-5. [PMID: 23930730 DOI: 10.1179/2046905513y.0000000056] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND Operation Smile is a non-profit organization that provides free cleft lip and cleft palate repair to impoverished children worldwide. To date, no longitudinal studies of satisfaction among these patients or their families have been published. OBJECTIVES In a cohort of parents of children receiving cleft lip/cleft palate repair, to assess parental satisfaction and fulfillment of expectations. METHODS A prospective cohort study with pre-operative and 6-month post-operative interviews of parents of 45 patients of the Operation Smile mission in Tegucigalpa, Honduras, 2007 was undertaken. Patients were recruited from a total of 96 who underwent surgery, with follow-up data available for 22 of them (49% of participants). Pre-operative interviews concerned expectations regarding surgery, and post-operative interviews addressed surgical outcomes and satisfaction. RESULTS Mean patient age was 4 years (range 3 months to 17 years); 51% underwent isolated cleft lip repair, and 49% cleft palate repair. This was the first surgery for 53%, the remainder having had previous surgery on one to six occasions. Pre-operatively, parents expressed expectations that speech (n = 26), appearance (n = 21) or feeding (n = 17) would improve. Among the 22 re-interviewed 6 months after surgery, two had experienced minor and one major post-operative complications. Only 14 of 22 had all their pre-operative expectations fulfilled. All except one parent reported satisfaction with the surgery. CONCLUSION Despite unmet expectations, parents of children who received medical mission surgery for cleft lip or cleft palate express satisfaction with outcomes. Other factors are likely to influence expressions of satisfaction in this setting.
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Zopf D, Joseph AW, Thorne MC. Patient and family satisfaction in a pediatric otolaryngology clinic. Int J Pediatr Otorhinolaryngol 2012; 76:1339-42. [PMID: 22763208 DOI: 10.1016/j.ijporl.2012.06.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2012] [Revised: 06/04/2012] [Accepted: 06/07/2012] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Identify factors related to patient/family satisfaction in an academic pediatric otolaryngology clinic and suggest strategies to improve patient and family satisfaction. METHODS Patients and families were surveyed following clinic encounters between May, 2010 and April, 2011. Review of an ongoing continuous quality improvement (CQI) effort. Univariable and multivariable ordinal logistic regression analyses were used to evaluate the relationship between reception area and examination room wait times, assessment of the provider, and clinic volume with overall satisfaction. RESULTS 1415 clinical encounters in the pediatric otolaryngology clinic resulted in 962 responses for a response rate of 68%. Ordinal logistic regression showed a significant relationship between overall satisfaction and satisfaction with the provider (cumulative odds ratio [COR]=51.0; 95% CI: 29.5, 88.2; P<0.001), examination room wait time (COR=23.0; 95% CI: 15.0, 35.1; P<0.001), reception area wait time (COR=13.6; 95% CI: 9.41, 19.8; P<0.001), and increases in clinic volume below 22 patients per day (COR=0.86; 95% CI: 0.75, 0.99; P=0.033). Multivariable analysis showed that satisfaction with provider (COR=32.2; 95% CI: 14.5, 71.8; P<0.001), reception area wait time (COR=3.8; 95% CI: 1.8, 7.6; P<0.001), and examination room wait time (COR=2.8; 95% CI: 1.3, 6.1; P=0.005) were independently associated with overall satisfaction. CONCLUSIONS Examination room wait times and reception area wait times are associated with overall satisfaction and should be minimized.
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Affiliation(s)
- David Zopf
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, MI, USA
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Abstract
Objectives: This study examined how patients’ satisfaction with their care is affected by racial/ethnic concordance and patients’ perceived interpersonal sensitivity of their providers. The sample consisted of non-Hispanic Whites, African Americans/Blacks, Hispanics/Latinos, and Asian Americans age 50 and older. Method: Data came from the population-based Commonwealth Fund 2001 Health Care Quality Survey ( n = 2,075). A hierarchical regression model of satisfaction was estimated for each racial/ethnic group with a sequential entry of variables: demographic and health-related variables, racial/ethnic concordance between patient and provider, and interpersonal sensitivity. Results: The influence of patient-provider racial/ethnic concordance on satisfaction with care was negligible, but the influence of interpersonal sensitivity was substantial ( p < .001) in all racial/ethnic groups. Discussion: Findings suggest that racial/ethnic concordance may not be universally effective for diverse older populations, but perceived interpersonal sensitivity of the provider has a strong influence on older adults’ satisfaction with care regardless of their racial/ethnic background.
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Affiliation(s)
| | | | - Yuri Jang
- University of South Florida, Tampa, FL, USA
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Klemenc-Ketis Z, Petek D, Kersnik J. Association between family doctors’ practices characteristics and patient evaluation of care. Health Policy 2012; 106:269-75. [DOI: 10.1016/j.healthpol.2012.04.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Revised: 04/17/2012] [Accepted: 04/19/2012] [Indexed: 11/29/2022]
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Vuković M, Gvozdenović BS, Gajić T, Stamatović Gajić B, Jakovljević M, McCormick BP. Validation of a patient satisfaction questionnaire in primary health care. Public Health 2012; 126:710-8. [PMID: 22831911 DOI: 10.1016/j.puhe.2012.03.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2011] [Revised: 02/09/2012] [Accepted: 03/19/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND Improvement in patient satisfaction with healthcare services can be evaluated by satisfaction questionnaires of high construct validity. OBJECTIVES To establish the dimensions and construct validity of a 20-item patient satisfaction questionnaire to assess satisfaction with general practice services. SUBJECTS In total, 1314 adult patients of both genders, who were users of healthcare services at the General Medicine Department of Health Centre Valjevo in Serbia for two consecutive years, were included in the study. METHODS Multidimensional scaling (MDS) was employed to identify similarities and dissimilarities among items comprising the satisfaction questionnaire. Patient satisfaction dimensions were estimated by principal component analysis for categorical data (CATAPCA). RESULTS The MDS model configuration derived two dimensions: (1) patient satisfaction with the timeliness of healthcare service provision; and (2) patient centredness related to doctors' and nurses' commitment towards their health. In the CATAPCA model, two dimensions of patient satisfaction were found: the first dimension patient satisfaction with medical staff and the second dimension was indicative of contextual patient dissatisfaction. CONCLUSIONS This study shows that the applied patient satisfaction questionnaire has high validity and reliability. It also has high sensitivity for longitudinal measurements, as well as good discriminatory power in measuring the different levels of patient satisfaction.
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Affiliation(s)
- M Vuković
- Quality Asurance Department, Health Centre Valjevo, Valjevo, Serbia.
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Land LM, Jobanputra P, Webber J, Ross JDC. Patient satisfaction in three clinics managing long-term conditions. ACTA ACUST UNITED AC 2012; 21:186-8. [PMID: 22584661 DOI: 10.12968/bjon.2012.21.3.186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
People with long-term conditions are frequent visitors to outpatient clinics. In order that they get the best out of their visits, the health professionals taking care of them need to understand their experiences and work towards service improvements. A survey of 3 clinics (HIV, rheumatology, diabetes) was undertaken using a set of three simple, open questions. A total of 147 people responded that, above all, care, attention, friendliness and efficiency were their most valued experiences. Shorter waiting times and cheaper car parking came up most frequently as sources of dissatisfaction. The study concludes that there were no distinct differences in the experiences of the patients in each clinic. All care needs were relatively simple and, on the whole, met.
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Affiliation(s)
- Lucy M Land
- Centre for Health and Social Care Research, Birmingham City University, UK
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Nabbuye-Sekandi J, Makumbi FE, Kasangaki A, Kizza IB, Tugumisirize J, Nshimye E, Mbabali S, Peters DH. Patient satisfaction with services in outpatient clinics at Mulago hospital, Uganda. Int J Qual Health Care 2011; 23:516-23. [PMID: 21775313 DOI: 10.1093/intqhc/mzr040] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To identify factors associated with general satisfaction among clients attending outpatient clinics in a referral hospital in Uganda. DESIGN Cross-sectional exit survey of patients and care-givers in selected outpatient clinics. SETTING Seven outpatients' clinics at Mulago National Referral and Teaching Hospital. MAIN OUTCOME MEASURES Mean score of clients' general satisfaction with health-care services. RESULTS Overall the clients' general satisfaction was suboptimal. Average satisfaction was higher among clients with a primary or secondary education compared with none, those attending HIV treatment and research clinic compared with general outpatient clients, and returning relative to new clients. Conversely, satisfaction was lower among clients incurring costs of at least $1.5 during the visit, and those reporting longer waiting time (>2 h). Client's perceived technical competence of provider, accessibility, convenience and availability of services especially prescribed drugs were the strongest predictor of general satisfaction. CONCLUSIONS This study highlights the important findings about outpatient services at Mulago hospital. The sub-optimal satisfaction scores for outpatient care strongly suggest that more could be done to assure that services provided are more patient centered. Significant factors including category of clinic visited, waiting time, costs incurred, accessibility of services and perceived providers' technical competence at this hospital should be explored by the Makerere University College of Health Sciences and Mulago hospital for potential improvements in quality of the health service delivered.
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Affiliation(s)
- Juliet Nabbuye-Sekandi
- Department of Epidemiology and Biostatistics, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganada.
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Hirsch O, Keller H, Albohn-Kühne C, Krones T, Donner-Banzhoff N. Pitfalls in the statistical examination and interpretation of the correspondence between physician and patient satisfaction ratings and their relevance for shared decision making research. BMC Med Res Methodol 2011; 11:71. [PMID: 21592337 PMCID: PMC3120809 DOI: 10.1186/1471-2288-11-71] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2010] [Accepted: 05/18/2011] [Indexed: 12/31/2022] Open
Abstract
Background The correspondence of satisfaction ratings between physicians and patients can be assessed on different dimensions. One may examine whether they differ between the two groups or focus on measures of association or agreement. The aim of our study was to evaluate methodological difficulties in calculating the correspondence between patient and physician satisfaction ratings and to show the relevance for shared decision making research. Methods We utilised a structured tool for cardiovascular prevention (arriba™) in a pragmatic cluster-randomised controlled trial. Correspondence between patient and physician satisfaction ratings after individual primary care consultations was assessed using the Patient Participation Scale (PPS). We used the Wilcoxon signed-rank test, the marginal homogeneity test, Kendall's tau-b, weighted kappa, percentage of agreement, and the Bland-Altman method to measure differences, associations, and agreement between physicians and patients. Results Statistical measures signal large differences between patient and physician satisfaction ratings with more favourable ratings provided by patients and a low correspondence regardless of group allocation. Closer examination of the raw data revealed a high ceiling effect of satisfaction ratings and only slight disagreement regarding the distributions of differences between physicians' and patients' ratings. Conclusions Traditional statistical measures of association and agreement are not able to capture a clinically relevant appreciation of the physician-patient relationship by both parties in skewed satisfaction ratings. Only the Bland-Altman method for assessing agreement augmented by bar charts of differences was able to indicate this. Trial registration ISRCTN: ISRCT71348772
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Affiliation(s)
- Oliver Hirsch
- Department of General Practice/Family Medicine, University of Marburg, Germany.
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Hirsch O, Keller H, Albohn-Kühne C, Krones T, Donner-Banzhoff N. Satisfaction of patients and primary care physicians with shared decision making. Eval Health Prof 2011; 33:321-42. [PMID: 20801975 DOI: 10.1177/0163278710376662] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Satisfaction with treatment is regarded as an important outcome measure, but its suitability has not been thoroughly investigated in the context of shared decision making (SDM). The authors evaluated whether both patients' and physicians' satisfaction ratings differ between an intervention group and a control group within a structured tool for cardiovascular prevention (ARRIBA-Herz). In a pragmatic, cluster-randomized, controlled trial, 44 family physicians in the intervention group consecutively recruited 550 patients whereas 47 physicians in the control group included 582 patients. Main findings were high satisfaction ratings independent of group allocation in patients and physicians. Significant differences had only negligible effect sizes. Compared to global satisfaction ratings, the effects of the shared decision-making process are better measured by a more concrete approach representing different steps of this process. Further research should refine behaviorally oriented questionnaires that measure SDM and a version for physicians should also be created.
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Affiliation(s)
- Oliver Hirsch
- Department of Family Medicine, Philipps University Marburg, Marburg, Germany.
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Couillerot-Peyrondet AL, Midy F, Bruneau C. [Perception of health care quality by patients with chronic conditions]. Rev Epidemiol Sante Publique 2011; 59:23-31. [PMID: 21251780 DOI: 10.1016/j.respe.2010.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2010] [Revised: 09/02/2010] [Accepted: 09/09/2010] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Patient opinion is becoming ever more important when considering healthcare quality and the reforms required to improve healthcare quality. The main aim of this study was to explore factors determining perceived healthcare quality among patients with chronic diseases. METHODS Data are drawn from the survey carried out in 2008 by the Commonwealth Fund, in partnership with the French Superior Health Authority (Haute Autorité de santé). The prospective telephone survey targeted adults in eight countries who had serious health problems (chronic or severe disease, declared poor state of health, hospital admission or major surgery). Of the 1202 French respondents, 851 had at least one diagnosed chronic disease. A multinomial logistic model was used to identify the relationship between perceived healthcare quality and patients' recent experience with the healthcare system. RESULTS People with chronic disease in general perceived that healthcare quality was excellent (45%) or good (44%). Only 11% of respondents judged it to be average or poor. There was a hint of "could do better", for example when considering podology and ophthalmology follow-up in diabetes or the management of multiple medications. The explanatory model revealed a positive correlation between excellent perceived healthcare quality and a strong doctor-patient relationship, taking into account both the length of this relationship and the ability of the doctor to involve the patient at all stages of decision-making concerning therapeutic management. There was no major link between the perceived quality of care and objective care quality, the quality of procedures, the cost of care to the patient or how frequently patients access the healthcare system. CONCLUSION The quality of the relationship between the patient and his/her doctor is a determining factor in the patient's judgement of the quality of healthcare he/she receives.
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Affiliation(s)
- A-L Couillerot-Peyrondet
- Haute Autorité de santé, 2, avenue du Stade-de-France, 93218 Saint-Denis La Plaine cedex, France
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Skaperdas I, Lavdaniti M, Dimitriadou A, Psychogiou M, Sgantzos M, Krepia V, Sapountzi-Krepia D. Satisfaction from the 'Help at Home' programme in a prefecture of central Greece. Int J Nurs Pract 2010; 16:342-51. [PMID: 20649665 DOI: 10.1111/j.1440-172x.2010.01850.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Greece is facing the issue of increasing elderly population and therefore local municipalities started the 'Help at Home' programme. The aim of this study is to investigate the elderly's satisfaction from the 'Help at Home' programme in a prefecture of central Greece. The sample consisted of 300 elderly people who receive services from the 'Help at Home' programme. Data were collected using a questionnaire. The majority of the participants were satisfied with the programme's services and reported high satisfaction from the interpersonal relations with the personnel, from the personnel's professional abilities and from the system's sufficiency in covering the elderly's perceived needs for care, but the satisfaction from the range of services is relatively low. The participants were overall satisfied; however, further research is needed at a national level in order to draw safer conclusion regarding the application of the programme in Greece.
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Buja A, Cavinato M, Perissinotto E, Rausa G, Mastrangelo G, Toffanin R. Why do patients change their general practitioner? Suggestions on corrective actions. Ir J Med Sci 2010; 180:149-54. [DOI: 10.1007/s11845-010-0571-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2008] [Accepted: 08/26/2010] [Indexed: 10/19/2022]
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Marcinowicz L, Rybaczuk M, Grebowski R, Chlabicz S. A short questionnaire for measuring the quality of patient visits to family practices. Int J Qual Health Care 2010; 22:294-301. [DOI: 10.1093/intqhc/mzq034] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Abstract
BACKGROUND During doctor-patient interactions, many messages are transmitted without words, through non-verbal communication. AIM To elucidate the types of non-verbal behaviours perceived by patients interacting with family GPs and to determine which cues are perceived most frequently. DESIGN OF STUDY In-depth interviews with patients of family GPs. SETTING Nine family practices in different regions of Poland. METHOD At each practice site, interviews were performed with four patients who were scheduled consecutively to see their family doctor. RESULTS Twenty-four of 36 studied patients spontaneously perceived non-verbal behaviours of the family GP during patient-doctor encounters. They reported a total of 48 non-verbal cues. The most frequent features were tone of voice, eye contact, and facial expressions. Less frequent were examination room characteristics, touch, interpersonal distance, GP clothing, gestures, and posture. CONCLUSION Non-verbal communication is an important factor by which patients spontaneously describe and evaluate their interactions with a GP. Family GPs should be trained to better understand and monitor their own non-verbal behaviours towards patients.
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