Combining Direct and Indirect Measurements to Assess Patients' Satisfaction with the Quality of Public Health Services in Romania: Uncovering Structural Mechanisms and Their Implications

Cancer Patients Satisfaction and Quality of Healthcare Services in Iraq: A Cross-Sectional Study to Evaluate the Quality of Care in Cancer Management

OBJECTIVE

Cancer is a complex disease characterized by uncontrolled cell proliferation and the development of metastatic features. The aim of the study is to examine the patient's satisfaction with the quality of healthcare services provided at the Middle Euphrates Cancer Centre in Al-Najaf Al-Ashraf Governorate.

METHODS

Cancer patients who visited during 2021-2023 Middle Euphrates Cancer Center in Al-Najaf Al Ashraf Governorate in 2021-2023 were enrolled in the study. In the cross sectional study, enrolled cancer patients were screened based on inclusion and exclusion criteria. In this study, cancer patient satisfaction assessment was made based on responses from a 59 items questionnaire.

RESULTS

In the study period, 400 cancer patients who visited the Middle Euphrates Cancer Center in Al-Najaf Al Ashraf Governorate enrolled in the study. Cancer patient's satisfaction was assessed based on the care provided by physicians, nurses, the infrastructure of the organization, and their socioeconomic status. Under the category of care provided by the physician, the level of assessment reported was low [L] =1-2.33; moderate [M] =2.34-3.66; 2.34-3.66, and high [H] =3.67-5). However, in the case of care provided by nurses, the level of assessment is low ([L] =1-2.33; moderate [M]=2.34-3.66; high [H]=3.67-5.0). The level of assessment (low [L] =1-2.33; moderate [M] = -3.66; high [H]=3.67-5) at the organization level for the services and facilities.

CONCLUSION

Findings clearly demonstrate that the participants were dissatisfied with some services provided by doctors, nurses, or organizations. The findings also emphasize the critical need to tailor healthcare services, enhance accessibility, and elevate the overall quality of care to enhance patient satisfaction significantly.

Antecedents of Patient Satisfaction in Private Clinical Laboratories toward Patient Loyalty with Switching Cost and Location as Moderating Factors (An Empirical Study from Indonesia)

BACKGROUND: Clinical laboratory services are at the forefront to support healthcare services, particularly during the pandemic of COVID-19. The increasing number of private clinical laboratories at present days indicates the increase in patient needs, causing the healthcare service provider to face challenges as people have more options. Therefore fostering patient loyalty (PL) is a crucial success factor for the business growth of clinical laboratories as healthcare providers.   AIM: The purpose of this study is to analyse antecedents of patient satisfaction (PS) in clinical laboratories towards PL with the switching cost (SC) and location (LO) as moderating factors. METHODS: This study was done as a quantitative survey, and data were obtained by a cross-sectional approach with partial least squares structural equation modeling (PLS-SEM) for the data analysis method. There are 266 respondents eligible as samples, who undergo the phlebotomy process in a private laboratory located within a specific area. RESULTS:  This study demonstrated that all the 9 hypotheses supported with α: 0.05 and p < 0.05, include 6 independent variables named administrative process (AP), information availability (IA), the environment in the phlebotomy room (ER), phlebotomy process (PP), waiting time (WT) and result notification (RN) that influence PS. Patient satisfaction has been shown to have a direct effect on patient loyalty and also mediate the antecedents. Furthermore, SC and LO have demonstrated a significant effect to moderate this relationship. CONCLUSIONS: Patient satisfaction has been confirmed as the main construct to predict PL whereas the AP is the most important independent variable followed by IA. Clinical laboratory management should pay more attention to these antecedents in order to ensure PS and retain the clinic’s patients. The cost from the patient's perspective should be taken into account since this helps the clinical laboratory keep the patient loyal.

Voluntary Simplicity and Green Buying Behavior: An Extended Framework

Green consumption is usually understood in the context of green consumption values and receptivity to green communication. Voluntary simplicity, a related yet distinct construct that relies on ecological responsibility, has not been included in the same framework. This paper bridges this gap and extends the original model to consider green consumption and voluntary simplicity in a unified structure. Based on a study conducted in Romania, it was found that 70% of the variation in buying behavior is explained by a combination of direct and mediated influences. The main takeaway is that any serious attempt to encourage responsible buying has to rely on a reduction in the absolute level of consumer demand. This result has far-reaching implications because the current paradigm of economic growth and prosperity is tributary to consumerism. The question is not how to avoid curtailing consumption and substitute green products for those harming the environment, but rather how to make voluntary frugality palatable.

Testing the Effectiveness of the Health Belief Model in Predicting Preventive Behavior During the COVID-19 Pandemic: The Case of Romania and Italy

We use a cultural psychology approach to examine the relevance of the Health Belief Model (HBM) for predicting a variety of behaviors that had been recommended by health officials during the initial stages of the COVID-19 lockdown for containing the spread of the virus and not overburdening the health system in Europe. Our study is grounded in the assumption that health behavior is activated based on locally relevant perceptions of threats, susceptibility and benefits in engaging in protective behavior, which requires careful attention to how these perceptions might be structured and activated. We assess the validity of the HBM in two European countries that have been relatively understudied, using simultaneous measurements during acute periods of infection in Romania and Italy. An online questionnaire provided a total of (N = 1863) valid answers from both countries. First, to understand individual difference patterns within and across populations, we fit a General Linear Model in which endorsement was predicted by behavior, country, their interaction, and a random effect for participants. Second, we assess the effect of demographics and health beliefs on prevention behaviors by fitting a multi-group path model across countries, in which each behavior was predicted by the observed health belief variables and demographics. Health beliefs showed stronger relationships with the recommended behaviors than demographics. Confirming previously reported relationships, self-efficacy, perceived severity, and perceived benefits were consistently related to the greater adoption of individual behaviors, whereas greater perceived barriers were related to lower adoption of health behaviors. However, we also point to important location specific effects that suggest that local norms shape protective behavior in highly contextualized ways.

Making Childhood Obesity a Priority: A Qualitative Study of Healthcare Professionals' Perspectives on Facilitating Communication and Improving Treatment

In Romania, one in four children has excess weight. Because childhood obesity is a sensitive topic, many healthcare professionals find it difficult to discuss children's excess weight with parents. This study aims to identify barriers and facilitators in childhood obesity-related communication, as perceived by healthcare professionals in Romania. As part of the STOP project, healthcare professionals (family physicians, pediatricians, and dieticians) who treat children with excess weight were invited to a telephone interview. The semi-structured questions were translated from a questionnaire previously used at the Swedish study site of the STOP project. Interviews were transcribed and then used for thematic analysis. Fifteen doctors and three dieticians (16 females and 2 males), with average 18.2 ± 10.1 years of experience, were interviewed. Four main themes were identified. Professionals reported that when children began experiencing obesity-related stigma or comorbidities, this became the tipping point of weight excess, where parents felt motivated to begin treatment. Barriers in communication were part of several layers of distrust, recognized as tension between professionals and caregivers due to conflicting beliefs about excess weight, as well as lack of trust in medical studies. Most respondents felt confident using models of good practice, consisting of a gentle approach and patient-centered care. Nonetheless, professionals noted systemic barriers due to a referral system and allocation of clinical time that hinder obesity treatment. They suggested that lack of specialized centers and inadequate education of healthcare professional conveys the system does not prioritize obesity treatment and prevention. The interviewed Romanian doctors and dieticians identified patient-centered care as key to treating children with obesity and building trust with their caregivers. However

their efforts are hindered by healthcare system barriers, including the lack of specialized centers, training, and a referral system. The findings therefore suggest that, to improve childhood obesity prevention and treatment, systemic barriers should be addressed.

Trial Registration:ClinicalTrials.gov, NCT03800823; 11 Jan 2019.

Determinants of Satisfaction with Services, and Trust in the Information Received in Community Pharmacies: A Comparative Analysis to Foster Pharmaceutical Care Adoption

Patient’s satisfaction with community pharmacy services, and patients’ trust in the information received in community pharmacies are important drivers of pharmaceutical care adoption. An online questionnaire assessing patient satisfaction with the services received in pharmacies and trust in the pharmacist’s advice, along with their determinants, was administered to 343 Romanian chronic and non-chronic patients. Using various statistical tests, exploratory factor analysis, and robust regression we explored determinants of satisfaction and trust. We found that satisfaction with services is predicted by pharmacists’ attitude (β = 631, p < 0.001), low waiting time (β = 0.180, p < 0.001), affordable cost of the drugs (β = 0.09, p = 0.009), and drug availability (β = 0.157, p < 0.001). At the same time, trust in the information received is driven by pharmacists’ attention (β = 0.610, p < 0.001), whether the patient received precautionary information (β = 0.425, p < 0.001), low waiting time (β = 0.287, p < 0.001), and whether the respondent is a chronic patient or not (non-chronic patients express more trust, β = 0.328, p = 0.04). Our study expands the existing paradigm that sees trust as a simple predictor of satisfaction by showing that trust and satisfaction are predicted by different variables, and thus they should be addressed using different strategies. In fact, we found that they share only one predictor—waiting time, highly significant in both cases. Our findings show that, without prioritizing trust in the information received in community pharmacies to reduce information asymmetry between patient and pharmacist, the focus only on patient satisfaction may lead to a scenario in which community pharmacies will end up to be better integrated in the business sector and not in the public health system.

Statistical Advances in Epidemiology and Public Health

The key role of statistical modeling in epidemiology and public health is unquestionable [...].

Measuring Patients’ Perception and Satisfaction with the Romanian Healthcare System

Measuring patient satisfaction of healthcare service quality represents a significant element of a healthcare’s system (HS) overall evaluation. It is the starting point for creating policies in national healthcare. The purpose of this paper was to evaluate Romanian patients’ perception and satisfaction of the quality of the national HS as a whole and of its components. Exploratory and descriptive research was used. Data were collected through face-to-face interviews with Romanian patients, based on a questionnaire. Out of the 2305 respondents, 83% used the Romanian HS in the past 12 months and 58% of the respondents did not trust the system. The accommodation, food, and other facilities of Romanian hospitals were perceived as being at a low level. One third of the respondents were unsatisfied and very unsatisfied with respect to the overall impression of the Romanian HS. In addition, our research found a statistically significant relationship between confidence in the HS, age, and gender, and also between the overall impression on the HS, age and income.