How do Twitter users feel about telehealth? A mixed-methods analysis of experiences, perceptions and expectations

BACKGROUND

Telehealth use has increased considerably in the last years and evidence suggests an overall positive sentiment towards telehealth. Twitter has a wide userbase and can enrich our understanding of telehealth use by users expressing their personal opinions in an unprompted way. This study aimed to explore Twitter users' experiences, perceptions and expectations about telehealth over the last 5 years.

METHODS

Mixed-methods study with sequential complementary quantitative and qualitative phases was used for analysis stages comprising (1) a quantitative semiautomated analysis and (2) a qualitative research-led thematic analysis. A machine learning model was used to establish the data set with relevant English language tweets from 1 September 2017 to 1 September 2022 relating to telehealth using predefined search words. Results were integrated at the end.

RESULTS

From the initial 237,671 downloaded tweets, 6469 had a relevancy score above 0.8 and were input into Leximancer and 595 were manually analysed. Experiences, perceptions and expectations were categorised into three domains: experience with telehealth consultation, telehealth changes over time and the purpose of the appointment. The most tweeted experience was expectations for telehealth consultation in comparison to in-person consultations. Users mostly mentioned the hope that waiting times for the consultations to start to be less than in-person, more telehealth appointments to be available and telehealth to be cheaper. Perceptions around the use of telehealth in relation to healthcare delivery changes brought about by the COVID-19 pandemic were also expressed. General practitioners were mentioned six times more than other healthcare professionals.

CONCLUSION/IMPLICATIONS

This study found that Twitter users expect telehealth services to be better, more affordable and more available than in-person consultations. Users acknowledged the convenience of not having to travel for appointments and the challenges to adapt to telehealth.

PATIENT OR PUBLIC CONTRIBUTION

An open data set with 237,671 tweets expressing users' opinions in an unprompted way was used as a source for telehealth service users, caregivers and members of the public experiences, perceptions and expectations of telehealth.

Satisfied versus dissatisfied: Experiences of retirement village living

OBJECTIVE

This study aims to understand and distinguish between satisfied and dissatisfied older people, through a comparison of their lived experience within a retirement village.

METHODS

An exploratory qualitative research design was utilized to identify and describe consumer experiences of lifestyle living and how that experience translates to positive or negative satisfaction. The net promoter score (NPS) was employed to identify highly satisfied (Promoters) and highly dissatisfied (Detractors) people.

RESULTS

Sixty-two interviews in retirement lifestyle villages were analysed, including satisfied (n = 33) and dissatisfied (n = 29) consumers of the service. Results reveal that satisfied people: (1) feel grateful for a service that exceeds their purchase expectations; (2) feel connected to others inside or (3) outside the lifestyle village; (4) feel 'heard' by the service provider; and (5) feel that they have retained their independence. Dissatisfied people describe: (1) broken promises, specifically those made at the time of purchase; (2) not feeling 'connected' to others inside the village; (3) feeling unheard or ignored by the service provider; and (4) the service not meeting their needs.

CONCLUSIONS

Revealing these detailed insights clarified the nuanced, hazy and often ambiguous differences between dissatisfied and satisfied people. It also provided insights into the high priority needs, expectations and choices of people as they transition into and through older age. The research should help industry, government and society in general to provide products and services that fit into this lived experience and better meet the changing needs of older people.

Menstrual Tracking Mobile App Review by Consumers and Health Care Providers: Quality Evaluations Study

BACKGROUND

Women's menstrual cycle is an important component of their overall health. Physiological cycles and associated symptoms can be monitored continuously and used as indicators in various fields. Menstrual apps are accessible and can be used to promote overall female health. However, no study has evaluated these apps' functionality from both consumers' and health care providers' perspectives. As such, the evidence indicating whether the menstrual apps available on the market provide user satisfaction is insufficient.

OBJECTIVE

This study was performed to investigate the key content and quality of menstrual apps from the perspectives of health care providers and consumers. We also analyzed the correlations between health care provider and consumer evaluation scores. On the basis of this analysis, we offer technical and policy recommendations that could increase the usability and convenience of future app.

METHODS

We searched the Google Play Store and iOS App Store using the keywords "period" and "menstrual cycle" in English and Korean and identified relevant apps. An app that met the following inclusion criteria was selected as a research app: nonduplicate; with >10,000 reviews; last updated ≤180 days ago; relevant to this topic; written in Korean or English; available free of charge; and currently operational. App quality was evaluated by 6 consumers and 4 health care providers using Mobile Application Rating Scale (MARS) and user version of the Mobile Application Rating Scale (uMARS). We then analyzed the correlations among MARS scores, uMARS scores, star ratings, and the number of reviews.

RESULTS

Of the 34 apps, 31 (91%) apps could be used to predict the menstrual cycle, and 2 (6%) apps provided information pertinent to health screening. All apps that scored highly in the MARS evaluation offer a symptom logging function and provide the user with personalized notifications. The "Bom Calendar" app had the highest MARS (4.51) and uMARS (4.23) scores. The MARS (2.22) and uMARS (4.15) scores for the "Menstrual calendar-ovulation & pregnancy calendar" app were different. In addition, there was no relationship between MARS and uMARS scores (r=0.32; P=.06).

CONCLUSIONS

We compared consumer and health care provider ratings for menstrual apps. Continuous monitoring of app quality from consumer and health care provider perspectives is necessary to guide their development and update content.

Active Usage of Mobile Health Applications: Cross-sectional Study

Background

Mobile health applications are being increasingly used for people’s health management. The different uses of mobile health applications lead to different health outcomes. Although active usage of mobile health applications is shown to be linked to the effectiveness of mobile health services, the factors that influence people’s active usage of mobile health applications are not well studied.

Objective

This paper aims to examine the antecedents of active usage of mobile health applications.

Methods

Grounded on the 3-factor theory, we proposed 10 attributes of mobile health applications that influence the active usage of mobile health applications through consumers’ satisfaction and dissatisfaction. We classified these 10 attributes into 3 categories (ie, excitement attributes, performance attributes, and basic attributes). Using the survey method, 494 valid responses were collected and analyzed using structural equation modeling.

Results

Our analysis results revealed that both consumer satisfaction (β=0.351, t=6.299, P<.001) and dissatisfaction (β=–0.251, t=5.119, P<.001) significantly influenced active usage. With regard to the effect of attributes, excitement attributes (β=0.525, t=12.861, P<.001) and performance attributes (β=0.297, t=6.508, P<.001) positively influenced consumer satisfaction, while performance attributes (β=–0.231, t=3.729, P<.001) and basic attributes (β=–0.412, t=7.132, P<.001) negatively influenced consumer dissatisfaction. The results of the analysis confirmed our proposed hypotheses.

Conclusions

Our study provides a novel perspective to study the active usage of mobile health applications. By categorizing the attributes of mobile health applications into 3 categories, the differential effects of different attributes can be tested. Meanwhile, consumer satisfaction and dissatisfaction are confirmed to be independent from each other.

Improving the Quality of Patient Care and Healthcare Staff Well-Being through an Empathy Immersion Educational Programme in New Zealand: Protocol of a Feasibility and Pilot Study

Empathy is positively related to healthcare workers and patients’ wellbeing. There is, however, limited research on the effects of empathy education delivered in acute clinical settings and its impact on healthcare consumers. This research tests the feasibility and the potential efficacy outcomes of an immersive education programme developed by the research team in collaboration with clinical partners and a multidisciplinary advisory group. Healthcare worker participants in the intervention ward will receive an 8-week immersive empathy education. The primary outcome (feasibility) will be assessed by evaluating the acceptability of the intervention and the estimated resources. The secondary outcome (efficacy) will be assessed using a quasi-experimental study design. Non-parametric tests will be used to test healthcare worker participants’ empathy, burnout, and organisational satisfaction (within-group and across groups), and healthcare consumer participants’ satisfaction (between-group) over time. Despite growing interest in the importance of empathy in professional relationships, to our knowledge, the present pilot study is the first to explore the feasibility and efficacy of an immersive empathy education in New Zealand. Our findings will provide critical evidence to support the development of a randomised cluster trial and potentially provide preliminary evidence for the effectiveness of this type of empathy education.

Impact of Pricing and Product Information on Consumer Buying Behavior With Customer Satisfaction in a Mediating Role

The relationship between product pricing and product packaging plays an important role in the buying behavior of consumers, whereas customer satisfaction plays a mediating role. To test these hypotheses, research was conducted on university students in China. Questionnaire-based convenience sampling was conducted on 500 students for data collection using online and offline sources. A total of 367 (73%) students responded, and 17 questionnaires were rejected due to missing information. SPSS and AMOS software were used for the data analysis. Product pricing and product information were independent variables in this study, whereas consumer buying behavior was a dependent variable. Customer satisfaction is mediated by one dependent and two independent variables. Confirmatory factor analysis, path analysis, and discriminant validity in structural equation modeling revealed that product pricing and packaging had a statistically significant relationship with the buyer decision process. The introduction of satisfaction as a mediating variable led to the observation of full mediation in the case of product pricing and partial mediation in product packaging. Given the results of this research, product managers should adopt pricing tactics along with product packaging to influence the buying intentions of consumers.

Psychometric Analysis of the 2016 Ohio Long-Term Care Facilities Family Satisfaction Scale

Although the Ohio Family Satisfaction Survey (OFSS) has been around since 2002 as an important indicator of long-term care facilities' performance, the validity of this scale has not been evaluated. Using the Robust Maximum Likelihood Estimator Method in Mplus, psychometric analysis involving second-order construct validity or hierarchical construct validity was conducted using responses from 1636 facilities including nursing homes and residential care facilities (N = 32,424). The results showed that OFSS retained the 7-factor structure for the 7 domains and the factor loadings for each domain were above 0.5. It is crucial to include families' input regarding quality of long-term care facilities as some older residents, especially those with moderate to severe cognitive impairments may be unable to provide consistent and comprehensive inputs about the quality of care and services they receive. Therefore, validation of the OFSS has an important implication for quality improvement practice.

Consumer's Satisfaction with Community Pharmacies in Sindh, Pakistan

Objective:

The present research is the first comprehensive cross-sectional study of consumer satisfaction with community pharmacies in Sindh, Pakistan. Moreover, the study has also designed a nonorder theoretical model for consumer satisfaction with community pharmacies.

Methods:

This is a cross-sectional descriptive study from a general population of Sindh, Pakistan, with a total of four hundred and fifteen (n = 415) participants. A confirmatory factor analysis was used to verify the factor structure between Pharmaceutical services (PS), the Skill of Pharmacists, Non-pharmaceutical services (NPS), and pricing (P). Pearson correlation analysis, Kendall's tau correlation analysis, and Spearman's rho correlation analysis were used to identify the correlation between different factors, such as PS, SKP, NPS, and P.

Findings:

The 23-item scale that consisted of four elements have shown an acceptable root mean squared error of approximation (0.076), Cronbach's alpha (0.787), and Chi-square value (3.381) (P < 0.001). Of the respondents, 56.4% rated their satisfaction on pharmacist attitude, whereas 67.2%, 41.4%, and 51.8% were satisfied with other services, such as receipt provided on medication they take, prescription drug service and availability of pharmacies on the weekend and public holidays, respectively

Conclusion:

This cross-sectional study confirms that there are relationships among PS, SPK, NPS, and P. Moreover, there is a lack of facilities in community pharmacies in Sindh, such as the unavailability of a consultation room, immunization services, information on routine health matters, and medication record.

How Does Happiness Influence the Loyalty of Karate Athletes? A Model of Structural Equations From the Constructs: Consumer Satisfaction, Engagement, and Meaningful

Federations are concerned about attracting new sportsmen and sportswomen and increasing the number of members. The purpose of this research was to describe karate federations' strategies for attracting and retaining members through happiness. The analysis was carried out by designing a structural equation modeling (SEM), which allowed to analyze the main variables that influenced the happiness of the karate athlete and consequently to study their effect on people's loyalty to sports federations. In particular, Partial least squares SEM was applied in an overall model when it was possible to understand the happiness role in relation with other traditional relevant variables on loyalty. The data were obtained through primary sources employing a survey sent to the autonomous federations in the discipline of karate, obtaining a sample of 682 federated members in Spain. The results of the model revealed that consumer satisfaction, engagement, and meaningful influence on consumer happiness, but engagement was the most important and relevant variable for affecting this variable. Finally, consumer satisfaction and consumer happiness influence loyalty, and consumer satisfaction was the most important variable, but consumer happiness showed a real alternative for improving loyalty in karate sports federations. Then, one of the implications of this work was that it helped to explain how the federations can be managed to achieve loyal consumers together with a more considerable increase in the number of federated members.

The Oncology Family Forum: Collaborating With Families to Codesign Pediatric Oncology Services

The Oncology Services Group at Queensland Children’s Hospital established an Oncology Family Forum in 2018 to enable codesign of service improvements. A total of 26 family members attended the first 4 Forums, with between 12 and 15 attendees at each. Attendees represented a range of diagnoses, were 85% female, 85% resided within 40 km of the tertiary center, and 26% were on-treatment. In a survey of attendees, 83% agreed that the Forum had improved families’ service experience and 92% supported the codesign partnership and the exploration of their suggestions. A small proportion (25%) of attendees disagreed that there was enough time to share, 17% disagreed that all their questions were answered, and 17% disagreed that the Forum represented views of regional families. Respondents identified collaboration, improving understanding and communication as positive aspects of the Forums. Forums will continue to be offered regularly, augmented by videoconferencing (particularly during the COVID-19 pandemic), written responses to family questions and special interest discussion groups. The new collaborations and programs that have been initiated, codesigned, and progressed through these Forums will continue to be the focus of service delivery and quality improvements.

Social Acceptance of Aquaculture in Andalusian Atlantic Coast (Spain): An Emerging Economy Sector

Aquaculture is an important source of food. This document analyses its acceptance by consumers from the perspective of social carrying capacity. This concept determines the point at which its development begins to be excessive, and poses difficulties to its geographical area. In this context, our work is innovative, since, although Spain is the leading aquaculture producer in the European Union, not much research on this aspect has been developed. With this objective, we carried out 579 personal interviews with consumers from the Andalusian Atlantic coast (Spain), to determine an index of acceptance for this food and its industry. After applying a principal component analysis, we stratified the samples following Dalenius-Hodges method. According to our surveys, there is a high level of acceptance, which would place aquaculture far from its saturation point, the level at which this sector generates relevant problems for society in terms of economy or environment. Respondents also recommended its further development. Women and low-income consumers were the groups with the greatest reticence about this sector. We consider that general acceptance would be improved by implementing informative campaigns, especially for these groups, that would extend consumers’ knowledge and improve their perception of this kind of food.

Validation of Newly Developed Surveys to Evaluate Patients' and Providers' Satisfaction with Telehealth Obstetric Services

Background: Patient and/or provider satisfaction and experience are among the most important indicators for quality assurance of health care services, including telehealth. Validated surveys should be used for this purpose to provide reliable information for a program evaluation. Objective: To validate the newly developed satisfaction surveys, report patient, and provider satisfaction with Antenatal and Neonatal Guidelines, Education and Learning Systems (ANGELS) telehealth services. Methods: Two self-administered paper surveys were developed by a multidisciplinary team. The surveys were validated among obstetric patients who received telehealth services in 2016 and providers in Arkansas from July to August 2017. Psychometric testing was performed to establish reliability and validity of both the surveys. Descriptive statistics was performed to describe patient and provider satisfaction. Results: A total of 89 patient- and 66 provider surveys were analyzed. Construct validity and internal consistency reliability (Cronbach's α >0.7) were confirmed on both the surveys. The majority of patients were highly satisfied with telehealth services and reported positive perceptions toward future use of services. In the past 12 months, telehealth (78.6%) was the most used ANGELS service by providers. Finally, >90% of the providers reported high satisfaction and rated telehealth services as "excellent." Conclusions: The newly developed patient and provider telehealth surveys were reliable and valid. The surveys also demonstrated that the telehealth services were well-accepted and highly valued in a sample of obstetric patients and providers. As both surveys are short, they can be used in routine evaluation of patient and provider satisfaction with similar telehealth programs in the country.

Reasons for choosing or refusing care from a nurse practitioner: Results from a national population-based survey

AIM

To understand the public's willingness or lack thereof, to be seen and treated by a nurse practitioner (NP) as the first point of contact when accessing healthcare services.

DESIGN

This cross-sectional, population-based survey study used computer assisted telephone interviewing to elicit public opinions on the topic.

METHODS

Data were collected in July and August 2015 from calls randomly placed to Australian households. Survey questions were developed from previous surveys and pilot tested. Summative content analysis was used to analyse open-ended responses.

RESULTS

Most respondents were always, or in some situations, willing to receive care from a nurse practitioner. The main themes identified from those willing to be seen by a nurse practitioner in any situation were, (a) appropriately qualified nurse practitioners, (b) the knowledge and experience to refer on if necessary. Description of situations from those unwilling to be seen by a nurse practitioner related to concern about appropriate care in a life-threatening condition.

CONCLUSION

Respondents unwilling to consider any care from a nurse practitioner or care in an emergency situation, reveal a lack of understanding of their role in the wider healthcare team. As the number of nurse practitioners increase, professional groups and community awareness programmes should be focused on explaining and promoting their essential role.

IMPACT

This study addresses the increasing healthcare requirements of ageing populations through understanding acceptance by society to the provision of care from health professionals other than medical practitioners. Most respondents were willing to be seen by a nurse practitioner for all or most of their healthcare needs. Lack of understanding of their scope of practice and role in the wider healthcare team, particularly in emergency situations, was reflected in responses. Those who would refuse care from a NP were in the minority. Appropriateness and acceptability of the roles of health professionals to provide quality care collaboration need consideration by policy makers.

Washington State Spirits Privatization: How Satisfied were Liquor Purchasers Before and After, and by Type of Retail Store in 2014?

BACKGROUND

In 2012 Washington State ended a wholesale/retail monopoly on liquor, permitting sale of spirits in stores with > 10,000 square feet. Implementation resulted in average price increases, but also five times the stores selling liquor.

OBJECTIVES

As part of a privatization evaluation, we studied pre-post and between-store-type purchase experiences.

METHODS

A 2010 Washington State Liquor Control Board (LCB) survey of liquor purchasers (n = 599), and the 2014 baseline of a repeated telephone survey (1,202 residents; n = 465 purchasers), each included 10 LCB questions on satisfaction with purchase experiences, each attribute with graded response scale A = 4 to D = 1 and F (0 = fail). Analyses used t-tests for satisfaction differences by time and analysis of variance (ANOVA) for 2014 between-store satisfaction-level differences.

RESULTS

Five purchase features were rated more favorably after privatization (ps < .05-.001), including product supply, staff professionalism, location convenience, store hours, and prices (though price rated lowest both times); selection offered, courtesy, and checkout speed were unaltered, and number of staff and staff knowledge declined (both p < .001). Eight consumer experiences differed by store type: five satisfaction aspects (supply, selection, number of staff, operating hours, and checkout speed) were highest for liquor superstores, while location convenience favored grocery and drug stores, and price satisfaction favored wholesale (Costco) stores, with staff knowledge highest at liquor stores.

CONCLUSIONS

Satisfaction with liquor purchases increased after privatization for half the consumer experiences. Availability (location convenience and store hours) was important to liquor purchasers. Such results are relevant to sustained support for the policy of privatizing spirits retail monopolies.

Consumer satisfaction with antipsychotic medication-monitoring appointments: the role of consumer-prescriber communication patterns

OBJECTIVE

The study was designed to explore patterns of prescriber communication behaviors as they relate to consumer satisfaction among a serious mental illness sample.

METHODS

Recordings from 175 antipsychotic medication-monitoring appointments between veterans with psychiatric disorders and their prescribers were coded using the Roter Interaction Analysis System (RIAS) for communication behavioral patterns.

RESULTS

The frequency of prescriber communication behaviors (i.e., facilitation, rapport, procedural, psychosocial, biomedical, and total utterances) did not reliably predict consumer satisfaction. The ratio of prescriber to consumer utterances did predict consumer satisfaction.

CONCLUSIONS

Consistent with client-centered care theory, antipsychotic medication consumers were more satisfied with their encounters when their prescriber did not dominate the conversation.

PRACTICE IMPLICATIONS

Therefore, one potential recommendation from these findings could be for medication prescribers to spend more of their time listening to, rather than speaking with, their SMI consumers.

Factors associated with professional satisfaction in primary care: Results from EUprimecare project

BACKGROUND

Given the importance of primary care to healthcare systems and population health, it seems crucial to identify factors that contribute to the quality of primary care. Professional satisfaction has been linked with quality of primary care. Physician dissatisfaction is considered a risk factor for burnout and leaving medicine.

OBJECTIVES

This study explored factors associated with professional satisfaction in seven European countries.

METHODS

A survey was conducted among primary care physicians. Estonia, Finland, Germany and Hungary used a web-based survey, Italy and Lithuania a telephone survey, and Spain face to face interviews. Sociodemographic information (age, sex), professional experience and qualifications (years since graduation, years of experience in general practice), organizational variables related to primary care systems and satisfaction were included in the final version of the questionnaire. A logistic regression analysis was performed to assess the factors associated with satisfaction among physicians.

RESULTS

A total of 1331 primary care physicians working in primary care services responded to the survey. More than half of the participants were satisfied with their work in primary care services (68.6%). We found significant associations between satisfaction and years of experience (OR = 1.01), integrated network of primary care centres (OR = 2.8), patients having direct access to specialists (OR = 1.3) and professionals having access to data on patient satisfaction (OR = 1.3). Public practice, rather than private practice, was associated with lower primary care professional satisfaction (OR = 0.8).

CONCLUSION

Elements related to the structure of primary care are associated with professional satisfaction. At the individual level, years of experience seems to be associated with higher professional satisfaction.

Longitudinal determinants of client treatment satisfaction in an intensive first-episode psychosis treatment programme

AIM

Previous evidence demonstrates that higher treatment satisfaction is strongly associated with improved clinical outcomes and functioning. The aim of the current study is to explore potential associations between clinical and demographic attributes, as well as changes in role, social and cognitive functioning occurring over the course of treatment, on self-reported treatment satisfaction within the context of an intensive first-episode psychosis intervention programme.

METHODS

Forty-four young adults attending a first-episode psychosis treatment programme completed a battery of clinical and neuropsychological measures at intake to the programme and again after 6 months of treatment. A modified version of the Client Satisfaction Questionnaire was administered at 6 months. Baseline, 6-month and change scores across the clinical and demographic measures were examined relative to the satisfaction questionnaire to evaluate determinants of treatment satisfaction.

RESULTS

Better premorbid adjustment during childhood and early adolescence was associated with higher treatment satisfaction, as did positive changes in clients' cognitive performance and their use of humour as a coping strategy. Clients' use of emotional support as a coping strategy at 6 months was also positively associated with treatment satisfaction. Although clients' social and role functioning improved significantly during the 6-month treatment window, changes in functional outcomes were not significantly associated with treatment satisfaction.

CONCLUSIONS

The current study highlights the role of premorbid adjustment and changes in coping and neurocognition as factors influencing treatment satisfaction. Future research designs might be able to more specifically ascertain causal relationships between patient characteristics, treatment components, client satisfaction and clinical effects.

Locally manufactured wheelchairs in Tanzania - are users satisfied?

BACKGROUND

The government of Tanzania created opportunity for the production of wheelchairs that would be appropriate to the local needs and environment.

OBJECTIVES

The study assessed the extent to which the wheelchairs met the activity and participation needs of the users, as well as the users' level of satisfaction with the provision, repair and maintenance of these wheelchairs.

METHODS

A descriptive cross-sectional analytical design was utilized to collect data through the administration of a questionnaire among 75 adult wheelchair users.

RESULTS

Participants had used wheelchairs for an average period of 9.3 years. Most participants (61%) had sustained spinal cord injuries, and used three-wheeler chairs (76%). More than 90% reported that their wheelchairs positively influenced their activity and participation needs, and 85% were satisfied with their ability to carry out daily activities. Participants expressed satisfaction with the durability of the wheelchairs (89%), and the professional services received (71%), but not with follow-up services (77%). There was difference in satisfaction with features of 3-wheeler and 4-wheeler rigid chairs (p=0.030).

CONCLUSION

The wheelchairs positively impacted participants' activity and participation needs. Participants were sat isfied with the features of the wheelchairs but not with follow-up services. The concerns of dissatisfied users should be addressed.

Consumer Satisfaction with Telerehabilitation Service Provision of Alternative Computer Access and Augmentative and Alternative Communication

Telerehabilitation (TR) services for assistive technology evaluation and training have the potential to reduce travel demands for consumers and assistive technology professionals while allowing evaluation in more familiar, salient environments for the consumer. Sixty-five consumers received TR services for augmentative and alternative communication or alternative computer access, and consumer satisfaction was compared with twenty-eight consumers who received exclusively in-person services. TR recipients rated their TR services at a median of 6 on a 6-point Likert scale TR satisfaction questionnaire, although individual responses did indicate room for improvement in the technology. Overall satisfaction with AT services was rated highly by both in-person (100% satisfaction) and TR (99% satisfaction) service recipients.

Concordance between patient satisfaction and the dentist's view: findings from The National Dental Practice-Based Research Network

OBJECTIVES

In this study, the authors examined the dentist's view of the patient's experience and concordance with the patient's rating of satisfaction.

METHODS

Practitioners from 197 practices in The National Dental Practice-Based Research Network recruited consecutively seen patients who had defective restorations that were replaced or repaired. At the end of the dental visit, the treating dentist and 5,315 patients completed and returned a survey that asked about the patient's satisfaction.

RESULTS

Most dentists viewed their patients as having been satisfied with the treatment experience (n = 4,719 [89 percent]) and as having perceived them as friendly (n = 5,136 [97 percent]). Dentists had less strong feelings about whether patients had a preference for the restorative material (n = 2,271 [43 percent]) or an interest in obtaining information about the procedure (n = 1,757 [33 percent]). Overall, patients were satisfied, and most of the time dentists correctly predicted this outcome. Among patients who were less than satisfied, there was a substantial subset of cases in which dentists were not aware of this dissatisfaction.

CONCLUSION

For improved patient-centered care, dentists should assess patients' desires, expectations and perceptions of the dental care experience and then manage or correct the expectations and perceptions as needed.

PRACTICAL IMPLICATIONS

By taking a patient-centered approach, dentists should seek to understand how patients evaluate and rate the services provided, thereby enabling them to focus on what each patient values most.

Parental satisfaction with inpatient care of children with cerebral palsy

AIM

Children with cerebral palsy (CP) have complex health-care needs. This study examines levels of parental satisfaction with inpatient care for children with CP at a tertiary care hospital to identify areas for improvement.

METHODS

Parents/guardians of children with CP and parents/guardians of children without a disability admitted to hospital completed a custom-designed questionnaire assessing six areas of the hospital admission: (i) the admission process; (ii) the child's personal care; (iii) the child's medical care; (iv) overall care of the child; (v) the parent's experience in hospital; and (vi) keeping up to date in hospital. Differences between the two groups were analysed using Student's t-tests.

RESULTS

Parents of children with CP were significantly less satisfied with the inpatient care as compared with parents of children without a disability in four of the six categories: 'my child's personal care' (P = 0.0033), 'my child's medical care' (P = 0.0350), 'overall care' (P = 0.0081) and 'my experience in the hospital' (P = 0.0209). When the overall questionnaire was compared between the two groups, parents of children with CP were less satisfied with care than parents of children without a disability (P = 0.0036).

CONCLUSION

Parents of children with CP are less satisfied with the inpatient care of their child compared with parents of children without a disability. This information should be instrumental in informing change to ensure that parent satisfaction levels improve to a level consistent with other children admitted to a tertiary care setting.

Acceptance among and impact on dental practitioners and patients of American Heart Association recommendations for antibiotic prophylaxis

BACKGROUND

The 2007 American Heart Association (AHA) guidelines for the prevention of infective endocarditis (IE) called for a major reduction in the number of patients recommended for antibiotic prophylaxis (AP) and redefined the dental procedures considered to put these patients at risk of acquiring the infection. The purpose of the authors' study was to determine the acceptance of these changes among and the impact of the changes on dentists and their patients.

METHODS

The authors sent a survey to a random sample of 5,500 dentists in the United States.

RESULTS

Ninety-five percent of the 878 respondents indicated that they saw patients who receive AP. More than 75 percent were either satisfied or very satisfied with the AHA guidelines, and the respondents indicated that they believed almost three-quarters of their patients also were pleased. Seventy percent of dentists, however, had patients who took antibiotics before a dental procedure even though the guidelines no longer recommend it.

CONCLUSIONS

Acceptance of the 2007 guidelines appears to be high, but controversy remains. Additional scientific data are needed to resolve these issues.

PRACTICAL IMPLICATIONS

The 2007 AHA guidelines have greatly simplified the identification of patients who need AP for dental procedures, given that, in general, far fewer people with cardiac abnormalities are considered to be at risk as a result of invasive procedures. Some physicians, however, continue to prescribe antibiotics for some patients whom the AHA no longer considers to need them. Patients also may choose to continue this practice themselves. There is ongoing controversy surrounding this common clinical question in dental practice, and the next guidelines from the AHA may change on the basis of data from future clinical studies.

What primary health-care services are Australian consumers willing to accept from nurse practitioners? A National Survey

BACKGROUND

Nurses are becoming increasingly important as providers of primary health care in Australia. In November 2010, Medicare provider rights and Pharmaceutical Benefits Scheme rights for nurse practitioners, working in private practice and in collaboration with a medical practitioner, were introduced in Australia. Although international evidence suggests that nurse practitioners would be appropriate and acceptable providers of care at the first point of contact, such as primary health care, there is little Australian evidence about what care consumers are willing to accept from nurse practitioners.

OBJECTIVES

To ascertain what care Australian health-care consumers would accept from nurse practitioners in this setting.

PARTICIPANTS

Australian adults over 18 years of age.

METHODS

National Survey delivered online. Information about the survey was disseminated through a media campaign, stakeholder engagement and through the health-care consumer networks nationally.

RESULTS

The total number of respondents that started the survey was n = 1883. Ninety-five percentage (n = 1784) of respondents completed the survey. The majority of respondents were women, aged 25-54 years, had completed tertiary education and had an annual household income of more than A$80,000. The majority of the respondents (n = 1562, 87%) said they would be prepared to see a nurse practitioner for some of their primary health-care needs.

CONCLUSIONS

The findings of this study suggest consumers are accepting of a range of activities undertaken by nurse practitioners in primary health care and this has relevance for primary health-care workforce mix and organization, particularly for areas that are underserved by medical practitioners.

Factors Associated with Parental Satisfaction with a Pediatric Crisis Clinic (PCC)

INTRODUCTION

Little is known about parental satisfaction with pediatric crisis clinics (PCCs) that provide a single consultation to families in need of urgent psychiatric care. Parental satisfaction may improve long-term adherence to physician recommendations.

OBJECTIVE

To explore parental satisfaction with a PCC.

METHODS

Parental satisfaction was ascertained by a structured telephone interview following crisis consultation at the PCC of an academic, tertiary care centre.

METHODS

Parents of 71% (n = 124) of 174 pediatric patients seen in the PCC from 2007-2008 participated in the post-consultation interview.

RESULTS

The majority of parents stated they were either somewhat satisfied (49/122, 40.2%) or very satisfied (49/122, 40.2%) with the PCC. Parental satisfaction correlated with time between referral and consultation (p<0.05), the degree to which parents felt listened to by the consultant (p<0.01), the amount of psychoeducation parents felt they received (p<0.01), and appointment length (p<0.001).

CONCLUSIONS

Parents were satisfied overall with an urgent care service model. Satisfaction was correlated with the time between referral and consultation, degree to which they felt their consultant had listened to them, and the amount of information they received at the consultation's conclusion.

A consumer satisfaction survey of civilly committed sex offenders in Illinois

The purpose of this study was to obtain feedback from civilly committed sex offenders (N = 113) about the components of treatment that they believed to be most important and helpful in preventing reoffense. Participants were also asked to rate their satisfaction with the treatment process and therapists. Victim empathy and accountability were rated as the most important elements of treatment, along with skills for preventing relapse and methods for controlling sexual arousal. There was a fairly robust correlation between client perceptions of importance and satisfaction on most treatment components. Some clients expressed concerns about respect, confidentiality, and judgmental attitudes of some therapists. Because civilly committed sex offenders are considered to be among the most likely to reoffend, strategies are discussed for engagement of this population in a meaningful process of change.

Level of user satisfaction with hearing AIDS and environment: the international outcome inventory for hearing AIDS

Introduction The main function of hearing is to enable oral communication. Hearing loss impairs communication skills.

Objective To evaluate the level of user satisfaction with hearing aids.

Methods This is a cross-sectional group study comprising 108 subjects (56% men and 44% women). The average age of the subjects was 77 years. These subjects had been recently fitted with their hearing aids and showed sensorineural (90%) and mixed (10%) hearing loss as determined via the Questionnaire International Outcome Inventory for Hearing Aids Outcome Inventory (IOI-HA), which determined the benefit and satisfaction obtained by sound amplification.

Results The hearing aids improved the quality of life of 52.78% of the patients, which was revealed by their high scores (mean = 27.3). The relationship of the user with the environment was significantly better (p < 0.001) than that of the user with the hearing aid.

Conclusion IOI-HA is a simple and easy-to-use tool. Based on the results of this study, we can show a high degree of satisfaction with their hearing aids in the majority of the participants, which improved the quality of life.

Satisfaction with information used to choose prostate cancer treatment

PURPOSE

After being diagnosed with prostate cancer men must assimilate information regarding the cancer. Satisfaction with information reflects the evaluation of information sources used before treatment to select a therapy. We describe the use and helpfulness of several information sources available to prostate cancer survivors. We also identified factors associated with satisfaction with information.

MATERIALS AND METHODS

A total of 1,204 men with newly diagnosed prostate cancer were enrolled in the prospective, multicenter Prostate Cancer Outcomes and Satisfaction with Therapy Quality Assessment study. The validated satisfaction with information domain of the Service Satisfaction Scale-Cancer was administered to subjects 2 months after treatment. The relationship between several factors, such as demographics, socioeconomic factors, cancer severity and types of information sources, and satisfaction with information were evaluated using multiple regression.

RESULTS

Sources of information endorsed by subjects varied by race, education and study site. The most helpful sources were treatment description by the treating physician (33.1%), Internet sites (18.9%) and books (18.1%). In multiple variable models patient age (p = 0.005) and information provided by the physician regarding outcomes in their patients (p = 0.01) were independently associated with patient satisfaction with the information provided.

CONCLUSIONS

Various information sources were used and endorsed as helpful by subjects, although results for physician patients was the only source independently associated with satisfaction with information. Providing patients with information about possible or expected courses of care and outcomes may improve satisfaction.

Can a multi-disciplinary assessment approach improve outcomes for children with attention deficit hyperactivity disorder?

OBJECTIVE

Public, consumer and professional views about attention deficit hyperactivity disorder, its assessment and treatment - especially with medication - remain a highly contested domain. Parents in particular express disquiet with services. One response to this tension is a multidisciplinary evaluation. Parental and education perceptions of this process have not been evaluated previously. A community multidisciplinary approach was assessed in terms of diagnostic outcomes and client satisfaction.

METHOD

A comprehensive multidisciplinary structured assessment of the first 50 referred children with severe attentional problems was documented. Demographic and symptom/behavioural profiles, developmental history and indicated multi-disciplinary evaluation were recorded. A team consensus process arrived at diagnostic classification. Post-assessment satisfaction of parents and school staff was surveyed.

RESULTS

Thirteen children (26%) were diagnosed with attention deficit hyperactivity disorder and three commenced stimulants. The majority of parents and educators were satisfied with the service.

CONCLUSIONS

A multidisciplinary assessment clinic for children presenting with attention problems resulted in minimal prescribing. Overall, education staff and parents were satisfied with the service. The model may be a suitable response to the multiple concerns in the community.

COPD patient satisfaction with ipratropium bromide/albuterol delivered via Respimat: a randomized, controlled study

Background

Ipratropium bromide/albuterol Respimat inhaler (CVT-R) was developed as an environmentally friendly alternative to ipratropium bromide/albuterol metered-dose inhaler (CVT-MDI), which uses a chlorofluorocarbon propellant.

Objective

The objective of this study was to evaluate patient satisfaction, device usage, and long-term safety of CVT-R compared to CVT-MDI, and to the simultaneous administration of ipratropium bromide hydrofluoroalkane (HFA; I) and albuterol HFA (A) metered-dose inhalers as dual monotherapies (I + A).

Design

This is a 48-week, open-label, randomized, active-controlled, parallel-group study (n = 470) comparing CVT-R to CVT-MDI and to I + A.

Participants

Patients were at least 40 years of age, diagnosed with chronic obstructive pulmonary disease (COPD), and current or exsmokers.

Interventions

Patients were randomized to receive: (1) CVT-R, one inhalation four times daily (QID); or (2) CVT-MDI, two inhalations QID; or (3) I + A two inhalations of each inhaler QID.

Main measures

Patient Satisfaction and Preference Questionnaire (PASAPQ) performance score (primary endpoint) and adverse events.

Key results

PASAPQ performance score was significantly higher (CVT-R versus CVT-MDI, 9.6; and CVT-R versus I + A, 6.2; both P < 0.001) when using CVT-R compared to CVT-MDI or I + A at all visits starting from week 3, while CVT-MDI and I + A treatment groups were similar. Time to first COPD exacerbation was slightly longer in the CVT-R group compared to the other treatment groups, although it did not reach statistical significance (CVT-R versus CVT-MDI, P = 0.57; CVT-R versus I + A, P = 0.22). Rates of withdrawal and patient refusal to continue treatment were lower in CVT-R compared with CVT-MDI and I + A groups (CVT-R versus CVT-MDI, P = 0.09; CVT-R versus I + A, P = 0.005). The percentage of patients reporting adverse events and serious adverse events was similar across all three treatment groups.

Conclusion

CVT-R is an effective, environmentally friendly inhaler that provides patients with a high level of user satisfaction and may positively impact clinical outcomes while having no adverse impacts on patients using the device.

The association between GP and patient ratings of quality of care at outpatient clinics

BACKGROUND

GPs and patients are frequently asked to evaluate mental health care, but studies including evaluations from both groups are rare.

OBJECTIVE

To assess the association between GPs' and patients' assessment of mental health outpatient clinic in Norway and identify important health care predictors for patient and GP satisfaction with the clinics.

METHODS

Two cross-sectional national surveys were carried out: survey of GPs in 2006 and patients in 2007 evaluating outpatient clinics at 69 community mental health centres in Norway. A total of 2009 GPs and 9001 outpatients assessed the clinics by means of a postal questionnaire. Main outcome measures were correlations between GP and patient ratings of the outpatient clinics at the clinic level and health care predictors for patient satisfaction and GP satisfaction with the clinics.

RESULTS

Clinic scores for GPs' and patients' assessment of waiting time were moderate to highly correlated (0.65), while clinic scores for GP and patient satisfaction had a lower but significant positive association (0.37). Significant positive correlations between clinic scores for GP and patients ratings were found for 38 of the 48 associations tested. The most important predictors for patient satisfaction with the clinics were interaction with the clinician (beta: 0.23) and being met with politeness and respect at the clinic (beta: 0.19), while the most important predictors for GP satisfaction with the clinics were perceived competence (beta: 0.25), rejection of referrals (beta: -0.17) and waiting time for patients (beta: -0.16).

CONCLUSIONS

A consistent positive association between GP and patient ratings at the clinic level was identified. Mental health services aiming at improving GP and patient satisfaction should be sensitive to the fact that the two groups prioritize different health care factors.

Ask the consumer: an innovative approach to dementia-related adult day service evaluation

Historically, family caregivers have been considered the "consumers" when evaluating respite programs for persons with dementia offered by adult day service (ADS) centers. The purpose of this article is to describe a unique evaluation of ADS conducted directly with persons with dementia. Seventeen persons who regularly attended the Silver Club, an ADS program associated with the University of Michigan Turner Geriatric Clinic, were interviewed by an independent, trained interviewer using a single group, one-time, cross-sectional administration of a consumer satisfaction survey. Fifteen persons were able to complete the interview successfully. The implication of this evaluation is that when specially designed procedures are used, persons with dementia are capable of contributing usable data to consumer satisfaction surveys. Including the voice of this vulnerable population improves the quality of an agency 's overall evaluation process and supports the basic philosophy of ADS to preserve the self-worth, independence, and dignity of cognitively impaired individuals.

Measuring orthodontic treatment satisfaction: questionnaire development and preliminary validation

OBJECTIVES

The aims of this study were to develop a reliable self-report measure of consumer satisfaction with orthodontic treatment, and to preliminarily assess its validity.

METHOD

Transcripts of qualitative interviews with patients, their parents, and practicing orthodontists together with items from existing dental satisfaction questionnaires were used to develop a pool of 41 items assessing satisfaction with various aspects of orthodontic care. These items were paired with five-point Likert scales (1 = strongly disagree, 5 = strongly agree) and were administered to 299 parents of children who had completed orthodontic treatment at two university-based clinics.

RESULTS

Factor analyses and reliability analyses identified three main subscales with high reliabilities: 13 items assessing satisfaction with treatment process (Cronbach's alpha = .92), seven items assessing satisfaction with psychosocial effects of treatment (Cronbach's alpha = .87), and five items assessing satisfaction with overall treatment outcome (Cronbach's alpha = .79). Relationships among these three subscales and pre- and posttreatment variables were examined in a subset of 86 parents/patients. Forward stepwise regression with backward overlook revealed no significant relationships between any satisfaction subscale and demographic variables. Posttreatment overjet was inversely related to parental satisfaction with orthodontic treatment process (R2 = .13; P < .001), and parent satisfaction with treatment outcome (R2 = .28; P < .0001). Improvement in esthetics as measured by improvement in IOTN Aesthetic Component scores was positively related to satisfaction with psychosocial outcomes (R2 = .28; P < .0001).

CONCLUSIONS

The present instrument is reliable and can be used to assess three dimensions of parental satisfaction with their child's orthodontic treatment. Relationships between visible orthodontic outcome variables and parent satisfaction provide preliminary validity support for the instrument.