Patient satisfaction with anaesthesia care: What is patient satisfaction, how should it be measured, and what is the evidence for assuring high patient satisfaction?

The revised patient satisfaction questionnaire (PSQ-R): validity, reliability, equivalence, and network analysis among hospitalized patients in the Chinese population

OBJECTIVES

The study of comprehensive satisfaction with healthcare is still limited due to nonstandard measurement tools of patient satisfaction for the Chinese population. Therefore, the present study aimed to verify the validity, reliability, and measurement invariance of the revised Patient Satisfaction Questionnaire (PSQ-R) and conducted network analysis among a sample of the Chinese population.

METHODS

A cross-sectional study using telephone surveys was conducted from April 2022 to August 2022. A total of 1377 participants who had been hospitalized completed the survey (481 males [34.9%], mean age = 49.4 years [SD ± 19.0]).

RESULTS

Four factors ('satisfaction with medical staff', 'satisfaction with hospital', 'satisfaction with medical costs', and 'satisfaction with medical insurance premiums'), were verified through confirmatory factor analysis (CFA) and had good equivalence across genders. The 'satisfaction with medical staff' and 'satisfaction with hospital' factors had the strongest edge intensity in the factor-level network.

CONCLUSIONS

The 18-item (four-factor) PSQ-R has good validity, reliability, and measurement invariance. The four dimensions appear to describe patient satisfaction well among the Chinese population who had been hospitalized. To effectively enhance patient satisfaction, the quality of healthcare service and medical staff skills should both be improved, medical insurance premiums should be increased, and medical costs should be decreased.

The effect of a 'Sip til Send' policy on patient satisfaction: a quality improvement project

Patients often are nil by mouth for prolonged periods pre-operatively, which is associated with adverse effects including discomfort, anxiety, thirst and nausea. As a result, several hospitals have introduced a more liberal regimen of pre-operative drinking, with patients encouraged to sip small volumes of water until transfer to the operating theatre ('Sip til Send'). The impact of 'Sip til Send' on patient satisfaction is still to be determined. We hypothesised that the introduction of a 'Sip til Send' policy would increase patient's satisfaction with their pre-operative fluid management regimen. We conducted a staged implementation of a 'Sip til Send' quality improvement initiative in two campuses of a large tertiary teaching hospital. This involved a targeted education and implementation programme that was refined and delivered through 'plan, do, study and act' cycles. Patient satisfaction with their pre-operative fluid management was measured by rating the statement "I am happy with the management of pre-operative drinking", against a five-point Likert scale (0, strongly disagree; 1, disagree; 2, neutral; 3, agree; and 4, strongly agree). Patient satisfaction with pre-operative fluid management was high at baseline, with pooled data for both campuses showing a median (IQR [range]) satisfaction score of 4 (3-4 [1-4]). After the implementation of 'Sip til Send', this improved to a median (IQR [range]) satisfaction score of 4 (4-4 [2-4]) (p < 0.001). The introduction of a 'Sip til Send' policy resulted in an increase in patient satisfaction. Key factors in successful implementation included the provision of a clear explanation of the underlying rationale to patients, nursing and anaesthetic staff, and establishing the policy as the default position for all elective patients.

Ambulatory anesthesia: restructuring for success

PURPOSE OF REVIEW

We review current evidence about organizational structures, patient selection criteria, safety measures, economic considerations, quality management, and staffing challenges in ambulatory anesthesia. The focus is on the facilitators and barriers related to the peri-interventional period and the potential concepts and innovations for the future development of ambulatory anesthesia services.

RECENT FINDINGS

Recent findings shed light on organizational structures in ambulatory anesthesia, including hospital-based centers, freestanding ambulatory centers, and office-based practices. Patient selection for ambulatory anesthesia involves a two-step process, considering both surgical and anesthetic factors. Safety measures, such as standardized guidelines and scoring systems, aim to ensure patient well being during the perioperative course. Economic considerations pose challenges due to the complexities of managing operating room efficiency and the variations in reimbursement systems. Quality management in ambulatory anesthesia emphasizes the need for outcome studies and patient-centered quality indicators. Staffing requirements necessitate highly skilled professionals with both technical and nontechnical skills, and structured education and training are essential.

SUMMARY

Ambulatory anesthesia is gaining importance due to advancements in surgical techniques and peri-interventional care. The review highlights the need for addressing challenges related to organizational structures, patient selection, patient safety, economic considerations, quality management, and staffing in ambulatory anesthesia. Understanding and addressing these factors are crucial for promoting the further development and improvement of ambulatory anesthesia services.

Patient-reported perioperative anaesthesia-related anxiety is associated with impaired patient satisfaction: a secondary analysis from a prospective observational study in Switzerland

Perioperative anxiety is common. The relationship between anxiety and patient satisfaction with anaesthesia is still under debate. We assessed the prevalence and different causes of anaesthesia-related fears leading to perioperative anxiety and its association with patient satisfaction. A multiple-time validated, psychometrically developed questionnaire assessing the presence of anxiety, causes of fear, and different dimensions of patient satisfaction was sent to patients after discharge. The clinical data were obtained from a previous study. The sample size was calculated to recruit a minimum of 300 completed questionnaires. Statistical analyses included multivariate logistic regression models. Complete data were available for 474 of the 600 patients recruited for the study (response rate: 79%). A total of 141 patients (30%) reported anxiety regarding anaesthesia before hospital admission. The prevalence of anxiety was significantly associated with patient age (< 54 years: n = 196, prevalence = 37%; > 54 years: n = 263, prevalence = 24%; p = 0.002), female sex (female: n = 242, prevalence 39%; male: n = 223, prevalence 20%; p < 0.001), and surgical speciality (gynaecology (n = 61, prevalence = 49%), otolaryngology (n = 56, prevalence = 46%); p < 0.001). Fear of not awakening from anaesthesia (n = 44, prevalence = 32%, SD 45.8) and developing postoperative nausea or vomiting (n = 42, prevalence = 30%, SD 46.0) were the most reported anaesthesia-related causes of fear. Anxiety was associated with impaired overall patient satisfaction (mean dissatisfaction score 15%, versus 23%, SD 16.3 in the anxious group, SD 16.3, p < 0.001), especially regarding the dimensions "information and involvement in decision-making" (14% of deficits stated in the non-anxious group compared to 23% in the anxious group, p < 0.001), "respect and trust" (2% vs 6.26%, p < 0.001) and "continuity of care" (50% vs 57%, p < 0.015). Patient-reported anaesthesia-related anxiety is common and may affect important outcome parameters such as patient satisfaction. Abstract presented in e-poster format at Euroanaesthesia 2023, June 3-5, Glasgow.

Patient Satisfaction With General Anesthesia Compared to Spinal Anesthesia for Cesarean Section: A Multicenter Observational Study

Background Satisfaction in patients undergoing cesarean section (CS) is of great importance in every hospital. There are big differences between spinal and general anesthesia for CS in terms of outcome, recovery times, and quality of service. Methods This multicenter observational study included 1443 patients who had elective (n=622) or emergency (n=821) CS in five medical centers over the period of 16 months. Bauer questionnaire was used for measuring patient satisfaction after CS. The questionnaire contained 15 questions about anesthesia-related discomfort and satisfaction with anesthesia care. Results During the study period, 1161 (80%) patients underwent CS under general anesthesia (GA) and 282 of them (20%) received spinal anesthesia (SA) for CS. The most frequently reported anesthesia-related discomfort was pain at the surgical site (>70%), drowsiness (68%), and thirst (60%). The data on patient satisfaction showed high satisfaction that exceeded 90%. Anesthesia side effects were less frequent and the general satisfaction rate was higher in the SA group compared to the GA group (P < .001). Conclusion SA for CS had less frequent side effects and a better satisfaction rate compared to GA for CS. Hospitals need to make room for improvement of postoperative acute pain control and introduction to Enhanced Recovery After Surgery (ERAS) protocols for elective CS.

Indonesia Translation and Cross-Cultural Validation of Pediatric Anesthesia Parent Satisfaction (PAPS) Questionnaire

BACKGROUND

Many questionnaires have been widely used to assess patient satisfaction. One of them is the Pediatric Anesthesia Parent Satisfaction (PAPS) questionnaire. However, in Indonesia, the parent satisfaction of pediatric patients undergoing surgery has never been studied. Knowing patient satisfaction can provide feedback to improve the quality of anesthesia services. Furthermore, the PAPS questionnaire has never been used in Indonesia, so it needs to be translated and tested for validity and reliability before being implemented in Indonesia.

AIM

to validate the Indonesian version of the PAPS questionnaire Method: This study uses a descriptive-analytic method with a cross-sectional design. The PAPS Questionnaire was translated into Indonesian version with the following steps (1) forward translation, (2) establish an expert committee, and (3) backward translation. After that, pilot testing and FGD with the expert were conducted to obtain the final questionnaire. Pearson's correlation and confirmatory factor analysis (CFA) were employed for the validity test. Sampling measurement before CFA was carried out with Keyser-Meyer-Olkin (KMO) and Bartlett's test. Cronbach's alpha determined the reliability test evaluation.

RESULT

Total number of subjects is 125 subjects. The PAPS questionnaire in the Indonesian version was obtained with help from INCULS and an anesthesiologist expert. Pearson's correlation found that all items ranged from r = 0.531-0.796 with p < 0.001. The CFA showed two factors that explained 65% of the total variance, with KMO being 0.937 (X2=1283.452, p < 0.001). Cronbach's alpha coefficient was 0.937.

CONCLUSION

Indonesian version of the PAPS questionnaire is valid and reliable for assessing parents' satisfaction with the anesthesia services their child received.

Relationship between nurses' psychological capital and satisfaction of elderly cancer patients during the COVID-19 pandemic

INTRODUCTION

As a special vulnerable group, the physical and mental health of elderly cancer patients has attracted much attention. However, few studies have focused on the impact of nurses' mental state on the mental health of elderly cancer patients during the COVID-19 pandemic. In response to this literature gap, this study aims to explore the impact of nurses' psychological capital on the satisfaction of elderly cancer patients. The job demands-resources model (JD-R) is used to further investigate how work engagement and job resources of nurses affect this relationship.

METHODS

The questionnaire survey was used to collect data, participants included 230 elderly cancer patients and their nurses from a tertiary first-class cancer hospital in China. Partial least squares structural equation modeling (PLS-SEM) was conducted with SmartPLS 3.3.9.

RESULTS

Nurses' psychological capital has a significant positive impact on the satisfaction of elderly cancer patients during the COVID-19 pandemic. Nurses' work engagement is an important mechanism for their psychological capital to affect the satisfaction of elderly cancer patients. In addition, nurses' job resources positively moderate the relationship between their psychological capital and work engagement. The positive relationship between psychological capital and work engagement of nurses is stronger when they have abundant job resources.

DISCUSSION

These findings suggest that healthcare organizations should take the psychological capital of medical staff as an important means to improve their competitive advantage. It can improve the quality of medical services to obtain good performance by effectively developing and managing the psychological capital of medical staff. In addition, healthcare organizations should recognize the importance of providing adequate job resources for medical staff.

Relationship between nurses’ psychological capital and satisfaction of elderly cancer patients during the COVID-19 pandemic

Introduction

As a special vulnerable group, the physical and mental health of elderly cancer patients has attracted much attention. However, few studies have focused on the impact of nurses’ mental state on the mental health of elderly cancer patients during the COVID-19 pandemic. In response to this literature gap, this study aims to explore the impact of nurses’ psychological capital on the satisfaction of elderly cancer patients. The job demands-resources model (JD-R) is used to further investigate how work engagement and job resources of nurses affect this relationship.

Methods

The questionnaire survey was used to collect data, participants included 230 elderly cancer patients and their nurses from a tertiary first-class cancer hospital in China. Partial least squares structural equation modeling (PLS-SEM) was conducted with SmartPLS 3.3.9.

Results

Nurses’ psychological capital has a significant positive impact on the satisfaction of elderly cancer patients during the COVID-19 pandemic. Nurses’ work engagement is an important mechanism for their psychological capital to affect the satisfaction of elderly cancer patients. In addition, nurses’ job resources positively moderate the relationship between their psychological capital and work engagement. The positive relationship between psychological capital and work engagement of nurses is stronger when they have abundant job resources.

Discussion

These findings suggest that healthcare organizations should take the psychological capital of medical staff as an important means to improve their competitive advantage. It can improve the quality of medical services to obtain good performance by effectively developing and managing the psychological capital of medical staff. In addition, healthcare organizations should recognize the importance of providing adequate job resources for medical staff.

Patient Satisfaction and Its Predictors With Perioperative Anesthesia Care at Two General Hospitals in Southwestern Saudi Arabia

Introduction  Patient satisfaction is one of the most crucial quality assessment and improvement indicators in anesthesia. Different factors reflect satisfaction such as postoperative pain, procedure duration, patient-physician relationship, inpatient services, and waiting time. A high level of satisfaction can lead to better outcomes in many ways, such as decreasing future surgeries fear and strengthening the healthcare system trust among the population. Therefore, this study aimed to evaluate the satisfaction level and its predictors with perioperative anesthesia care among patients subjected to different surgeries in two general hospitals in southwestern Saudi Arabia. Methodology  A cross-sectional study was conducted among patients admitted to different surgical specialties at two general hospitals in Al-Qunfudhah governorate in October 2022. Data were collected through interviews with postoperative patients and checking their medical data from the patient's medical reports. However, all surgical patients aged more than 18 consider as inclusion. In contrast, intensive care unit (ICU) admission, local anesthesia, refusal to participate, and cognitive and communication impairment are the exclusion. Perioperative patient satisfaction was assessed using the Leiden Perioperative Care Patient Satisfaction Questionnaire (LPPSq). Results Eighty-three of 201 patients were included in the final analysis. The overall level of patient satisfaction concerning perioperative anesthetic care was calculated to be 73.5%. Hospital setting, admission type, BMI, and smoking were statistically associated with perioperative anesthesia patient satisfaction. Additionally, the most frequently reported unpleasant anesthetic side effect was shivering, followed by postoperative pain at a frequency of 42 (50.6%) and 37 (44.6%), respectively. Conclusion A moderate level of patient satisfaction concerning perioperative anesthetic care was detected. Smoking, BMI, admission type, and hospital setting were significantly associated predictors for patients' satisfaction. In order to present a complete picture, we recommend that future research concentrate on additional elements of patient satisfaction, particularly operating room turnover and standards for discharge. Additionally, we propose a routine evaluation before patients' discharge when patients are altering and oriented. Periodic evaluation and enhancement of patient satisfaction with perioperative anesthetic care should be employed and promoted.

Patient satisfaction with quality of care in public hospitals in Albania

Healthcare service quality and hospitalized patient satisfaction in Albania have never truly received the necessary attention. The aim of this study is the assessment of key elements of service quality and their relationship with patients' satisfaction with receiving healthcare at public health institutions in Albania. The study examines five key dimensions of quality such as responsiveness, reliability, assurance, tangibles, and staff empathy to assess properly the healthcare quality and patient satisfaction in Albania based on the SERVQUAL instrument, which measures the differences between patient's perceptions of service quality received, and their expectations in terms of these five dimensions. A total of 800 randomly selected patients were interviewed in the main cities of Albania in public hospitals. A respective literature review was also a necessity to determine not only the appropriate methodology to be applied, together with the right quality dimensions to use but also for a better understanding of the link between service quality and patient satisfaction. The determination of the main quality factors which contribute to patient satisfaction, as well as, their order of importance, is another key aspect of the study, which finalizes with appropriate recommendations that might help quality improvement in future. The analysis shows that overall patient satisfaction is affected in public hospitals by all dimensions of service quality. Therefore, patients' perspective is extremely important in assessing healthcare service quality and should be taken into consideration by healthcare managers and policymakers in Albania, whenever significant reforms will be undertaken to improve the quality of services in this sector.

What matters to patients following total knee arthroplasty? A grounded theory of adapting to a knee replacement

Background

Globally the volume of total knee arthroplasty (TKA) is on the rise, reflecting aging populations, an associated increase in treatment of osteoarthritis, and a desire for improved quality of life. There is evidence that as high as 15 to 20% of patients are not satisfied with their TKA results and efforts need to be made to improve these rates. This study set out to identify what patients consider important when reflecting on TKA satisfaction, to pave the way to identifying service transformation opportunities that will enhance patient-centred care and satisfaction with this procedure.

Methods

Twenty-seven TKA recipients were recruited in the province of British Columbia, Canada. Semi-structured interviews were conducted about participants’ experience and satisfaction with TKA, three to four years post-surgery. Grounded theory was employed to analyze participants’ stories about what was front of mind when they reflected on satisfaction with their new knee.

Results

Participants described their post-TKA knee in terms its adequacy: how it felt and worked, and how it matched their pre-surgical expectations. The central element of their stories was the process of adapting, which gave rise to their perceptions of adequacy. Adapting comprises the patient experience of physically integrating and cognitively accepting their new knee. Patterns of adapting reflect the level of the new knee’s achieved adequacy and the straightforwardness of the adapting process.

Discussion

The conceptualization of adequacy and the process of adapting allow a patient-centred understanding of what patients experience following TKA. For participants who did not readily achieve the adequacy they had anticipated, the challenges they experienced during adapting dominated their stories. Participants’ adapting stories afford key insights into how the health care system could adjust to better support TKA patients, and improve rates of satisfaction with this procedure.

Conclusions

The process of adapting lends itself to system intervention in support of enhanced post-TKA outcomes and satisfaction. These interventions could include the development of a care model including long-term clinical support for patients whose knees do not achieve desired results on schedule, and collaborating with patients to set and manage reasonable expectations about how their post-TKA knee will feel and function.

Treatment Satisfaction in a Civil Commitment Facility for Sexually Violent Persons

Evaluating patient satisfaction in therapeutic settings is consistent with a Risk-Needs-Responsivity (RNR) model. This study provides results from a program improvement initiative in a sexually violent person (SVP) civil commitment facility that queried patients and treatment providers about their satisfaction with therapeutic processes and assessment methods. Overall, patients reported high levels of satisfaction with treatment at the facility, with the highest levels of satisfaction on items about being treated with kindness and respect and staff acting professionally. Providers rated current assessment methods such as the Penile Plethysmography (PPG) assessment, polygraph testing, and neuropsychological testing as most helpful for patients in treatment progress; however, patients rated PPG assessment and polygraph testing as the least helpful of the assessments conducted. Soliciting patient feedback periodically could be important for maintaining treatment engagement and discovering opportunities to enhance patient satisfaction to treatment in a SVP civil commitment setting.

Patient Satisfaction Survey on Perioperative Anesthesia Service in University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia, 2021

Background

Patient satisfaction is a crucial component in determining the quality of healthcare in anesthesia services. This study aimed to assess patient satisfaction and associated factors on perioperative anesthesia services.

Methods

Institutional-based cross-sectional study was conducted from May 16 to June 22, 2021, at the University of Gondar Comprehensive Specialized Hospital. Data were entered into Epi-data version 3.1 and exported to STATA version 14.1. The strength of the association was presented using an adjusted odds ratio with a 95% confidence interval, and a p value <0.05 was considered as statistically significant.

Results

A total of 398 patients were included in this study with a response rate of 98%. The overall proportion of patients who were satisfied with perioperative anesthesia service was 74% (95% CI: 69–78). Patients who received regional anesthesia were 2.8 times satisfied than those who received general anesthesia (AOR = 2.8, 95% CI: 1.42–5.36). Patients who obtained adequate information was 3.14 times (AOR = 3.14, 95% CI: 1.71–5.74) satisfied than that of the counterpart. Adults who did not feel pain during induction of anesthesia were 2.7 times (AOR = 2.7, 95% CI: 1.43–5.08) satisfied than an adult who felt pain during induction of anesthesia. Conclusion and Recommendations. The overall patients' satisfaction on perioperative anesthesia service was 74%. Patients who underwent operation with regional anesthesia, obtained adequate information about anesthesia, visited by anesthetists after operations, did not have nausea/vomiting, did not feel pain during induction, and patients who did not feel pain immediately after operation were satisfied than the counterparts. We recommended that the anesthetists must give attention to reduce the factors that decrease the satisfaction level of the surgical patients.

Patient satisfaction with perioperative nursing care in a tertiary hospital in Ghana

PURPOSE

Promoting patient satisfaction is crucial for healthcare quality improvement. However, literature on patient satisfaction with nursing care in Ghana is limited. The aim of this study was to assess patient satisfaction with perioperative nursing care in Korle-Bu Teaching Hospital, the largest tertiary hospital in Ghana.

DESIGN/METHODOLOGY/APPROACH

The study was a cross-sectional study. A sample of one hundred (n = 100) in-patients in the surgical department were interviewed. Statistical Package for Social Science (SPSS), version 22, was used to analyze the data. The results were presented using univariate, bivariate and multivariate analyses.

FINDINGS

It was found that majority of the respondents were males (53%), employed (56%) and insured (85%). It was also found that eight in ten respondents were satisfied with the perioperative nursing care. Overall patient satisfaction with perioperative nursing care was significantly associated with information provision (p < 0.001), nurse-patient relationship (p < 0.001), fear and concern (p < 0.05) and discomfort and need (p < 0.05). At the multivariate level, overall patient satisfaction was significantly influenced by nurse-patient relationship (β = 0.430, p = 0.002).

ORIGINALITY/VALUE

There is limited literature on nursing care in surgical departments and rarely are patients' views considered in assessing quality of perioperative care, especially in Low- and Middle- Income Countries (LMICs). This study is a modest contribution to the literature on patient satisfaction with perioperative nursing care in Ghana.

Automated rating of patient and physician emotion in primary care visits

OBJECTIVE

Train machine learning models that automatically predict emotional valence of patient and physician in primary care visits.

METHODS

Using transcripts from 353 primary care office visits with 350 patients and 84 physicians (Cook, 2002 [1], Tai-Seale et al., 2015 [2]), we developed two machine learning models (a recurrent neural network with a hierarchical structure and a logistic regression classifier) to recognize the emotional valence (positive, negative, neutral) (Posner et al., 2005 [3]) of each utterance. We examined the agreement of human-generated ratings of emotional valence with machine learning model ratings of emotion.

RESULTS

The agreement of emotion ratings from the recurrent neural network model with human ratings was comparable to that of human-human inter-rater agreement. The weighted-average of the correlation coefficients for the recurrent neural network model with human raters was 0.60, and the human rater agreement was also 0.60.

CONCLUSIONS

The recurrent neural network model predicted the emotional valence of patients and physicians in primary care visits with similar reliability as human raters.

PRACTICE IMPLICATIONS

As the first machine learning-based evaluation of emotion recognition in primary care visit conversations, our work provides valuable baselines for future applications that might help monitor patient emotional signals, supporting physicians in empathic communication, or examining the role of emotion in patient-centered care.

Facebook Reviews as a Supplemental Tool for Hospital Patient Satisfaction and Its Relationship with Hospital Accreditation in Malaysia

Patient satisfaction is one indicator used to assess the impact of accreditation on patient care. However, traditional patient satisfaction surveys have a few disadvantages, and some researchers have suggested that social media be used in their place. Social media usage is gaining popularity in healthcare organizations, but there is still a paucity of data to support it. The purpose of this study was to determine the association between online reviews and hospital patient satisfaction and the relationship between online reviews and hospital accreditation. We used a cross-sectional design with data acquired from the official Facebook pages of 48 Malaysian public hospitals, 25 of which are accredited. We collected all patient comments from Facebook reviews of those hospitals between 2018 and 2019. Spearman's correlation and logistic regression were used to evaluate the data. There was a significant and moderate correlation between hospital patient satisfaction and online reviews. Patient satisfaction was closely connected to urban location, tertiary hospital, and previous Facebook ratings. However, hospital accreditation was not found to be significantly associated with online reports of patient satisfaction. This groundbreaking study demonstrates how Facebook reviews can assist hospital administrators in monitoring their institutions' quality of care in real time.

Validated tool for quality assessment of anesthesia services by cardiac surgeons

Background and Aim:

The role of the cardiac anaesthesiologists extends beyond mere patient wellbeing to diagnostic input and active participation in decision making during cardiac surgery. The quality of service provision should therefore be judged not only by patient satisfaction but also by the satisfaction of cardiac surgeons. Unfortunately, quantification of cardiac surgeon satisfaction remains a challenge due to the absence of a reliable and validated tool. We therefore attempted to develop a robust, validated, pilot psychometric questionnaire, to measure satisfaction of cardiac surgeons' to cardiac anesthesia services.

Methods:

The questionnaire was developed with the help of senior cardiac anesthesiologist, cardiac surgeon and statistician with database search in PubMed and the Cochrane Library. The questionnaire was tested for content validity, comprehensibility, and identification of new items. This generated the second version of the questionnaire with nine socio-demographic and professional questions, 46 Likert type questions, an abridged Marlowe Crowne Social Desirability scale and one open ended question. This questionnaire was e-mailed to 100 cardiac surgeons requesting them to participate via a web-based survey application.

Results:

Content validity of the responses was tested by Aiken's content validity coefficient (V). Internal consistency was tested with Chronbach's alpha. Fifty-two cardiac surgeons participated in the survey. Twelve Likert type questions were deleted due to low V values. Excellent Chronbach's alpha (0.94) was obtained in the remaining 34 items.

Conclusions:

We have developed a questionnaire that includes 34 variables and allows quantifying surgeon satisfaction in a reliable fashion and is validated for the purpose.

Patient Satisfaction in Medicine and Dentistry

Health professionals, such as medical and dental clinicians, have scant understanding of patients' experiences and perceptions of satisfaction. Nevertheless, implementing a patient-reported outcome measures (PROMs) research practice in surgical sciences is necessary. Hence, the objective of this article was to better understand patients' satisfaction with their medical and dental care. The methods of the current article are based on a narrative review of the literature strategy. A literature review was conducted using both EMBASE and Medline databases up to July 12, 2020, by combining keywords and terms related to “satisfaction theories” and “patient satisfaction,” and “medicine” or “dentistry/stomatology/odontology.” Patient satisfaction's multidimensional nature has been established since the perceived reasons for satisfaction varied widely among patients. Many aspects of treatment influence participant satisfaction at different stages of the intervention process. An improved understanding of the basis for managing patients' expectations with information reiteratively and efficiently may ultimately reduce patients' potential for negative feelings toward the medical and dental treatment experience. Lastly, the consumerist method may misrepresent the still undertheorized concept of satisfaction in health service.

Construction, Factor Structure, and Internal Consistency Reliability of the Hospital Physical Therapy Perceived Satisfaction Questionnaire (H-PTPS)

Patient satisfaction is a crucial aspect in the evaluation of the quality of health care provided by health services and units, especially in patients that require physical rehabilitation. This study aims to design and analyze the factor structure and internal consistency reliability of the Hospital Physical Therapy Perceived Satisfaction Questionnaire (H-PTPS) measuring the level of physical therapy patient satisfaction in hospital rehabilitation services. This study has a multicenter cross-sectional survey design. This study used the structural validity and internal consistency domains from COSMIN (consensus-based standards for the selection of health status measurement instruments) guideline. The H-PTPS questionnaire consists of 20 closed questions. A sample of 384 adult patients from physical therapy units from three Spanish public hospitals completed this questionnaire. A factor structure and internal consistency reliability analysis were performed. The factor analysis including the 20 items of the H-PTPS showed an adequacy index of 0.922 according to the Kaiser–Meyer–Olkin measure and the Barlett test allowed us to reject the null hypothesis (p < 0.001). In the rotated component matrix, four specific factors were obtained, explaining 66.75% of the accumulated variance. All factors present satisfactory internal reliability, achieving Cronbach’s alpha indices and Omega coefficients higher than 0.74. The H-PTPS questionnaire has shown a four-factor solution with satisfactory reliability evaluating the satisfaction of Spanish patients treated in physical therapy units in the hospital rehabilitation services.

Investigating client satisfaction with antiretroviral treatment services in South-South Nigeria

Client satisfaction is a key method of evaluating the quality of healthcare services. This research investigated client satisfaction with anti-retroviral treatment services in selected outpatient facilities in Rivers State. This study was a qualitative study carried out in four antiretroviral treatment (ART) facilities in Rivers State, Nigeria. Researchers conducted nine Key Informant Interviews (KIIs), 25 In-depth interviews (IDIs) and eight Focus Group Discussion (FGDs) among 73 Persons Living with HIVs (PLHIVS) consisting of 31 males and 42 females, using a topic guide. Interviews were recorded, transcribed and analysed using thematic content analysis. Majority of study participants interviewed reported being very satisfied with confidentiality, health worker attitude, interpersonal communication, counselling, and availability of drugs. The major sources of dissatisfaction included overcrowding, long waiting time and inadequate/expensive laboratory services. Suggestions proffered for improving the quality of care at the centres included increasing staff strength at the treatment centres, improving the quality and cost of laboratory services, and infrastructure upgrade. This study demonstrates the role health workers and facility processes play in satisfaction with services at HIV treatment centres. Health workers, programme officers, and managers in HIV prevention, care and treatment need to pay attention to these issues if they would be successful in improving the quality of care for PLHIVs.

Parental Satisfaction with Ambulatory Anesthesia during Dental Treatment for Disabled Individuals and Their Preference for Same in Future

The purpose of this study was to survey parental satisfaction with ambulatory anesthesia during dental treatment in disabled patients. Factors associated with parental preference for general anesthesia during future dental treatment in such patients were also investigated. A questionnaire was mailed to the parents of 181 disabled individuals who underwent dental treatment under ambulatory anesthesia at Tokyo Dental College Suidobashi Hospital between 2012 and 2016. A total of 71 responses were received (39.2%). The mean patient age was 18 years, and disabilities included autism spectrum disorder, intellectual disability, cerebral palsy, and epilepsy. The items surveyed included dental treatment details, number of times patients received general anesthesia, type of anesthetic used, anesthesia induction method, durations of treatment and anesthesia, and the presence or absence of intraoperative or postoperative complications. Questionnaire items queried problems related to dental care, anesthesia history, preoperative anxiety, length of fasting period, induction of general anesthesia, nursing and hospital room environment, postoperative anxiety, overall evaluation, and whether the parent would prefer general anesthesia during future dental treatment. The patients were divided into 2 groups: those whose parents preferred general anesthesia during future dental treatment and those whose parents did not. The results revealed that, where disabled individuals had previously received general anesthesia during dental treatment, the parents were more likely to prefer general anesthesia during future dental treatment.

Satisfaction of psychiatric inpatients in China: clinical and institutional correlates in a national sample

BACKGROUND

Surveying patients' satisfaction is essential to improve patient-centered care, however, studies on satisfaction and their correlates among psychiatric inpatients are rare in China. This study aimed to measure satisfaction levels of psychiatric inpatients in a national sample and to examine individual and institutional correlates.

METHODS

As part of the National Survey for the Evaluation of Psychiatric Hospital Performance, psychiatric inpatients from 32 tertiary psychiatric hospitals in 29 Chinese provinces were interviewed on the day of discharge by trained research staff. Satisfaction was assessed using a five-item questionnaire. Patients' sociodemographic and clinical information were manually retrieved from medical records and institutional data were provided by participating hospitals. Multilevel linear regression was used to assess factors associated with level of satisfaction.

RESULTS

Among 1663 inpatients, the reported satisfaction levels were high, with a mean score of 23.3 ± 2.4 out of 25. Education level was positively associated with global satisfaction, satisfaction with costs, and satisfaction with privacy protection. Treatment response was associated with global satisfaction and with the doctor-patient communication subscore. The number of psychotherapy sessions was positively associated with the privacy protection subscore (coefficient = 0.0, P = 0.046). The Global Assessment of Function score was positively associated with the doctor-patient communication subscore (coefficient = 0.0, P = 0.003). Total satisfaction scores and all five subscores were positively associated with hospital-level factors, and patients discharged from hospitals with better staffing and resources reported significantly higher levels of satisfaction.

CONCLUSION

Overall, psychiatric inpatients in China were satisfied with the services they received. To further improve patient satisfaction, mental health professionals should optimize their patients' treatment response as much as possible before discharge and provide more psychological treatment during the hospitalization. The government should also provide more resources to increase the number of mental health professionals (nurses, psychologists, and psychiatrists) working in psychiatric hospitals.

A comprehensive analysis of patient satisfaction with anesthesia

Background:

Patient satisfaction with anesthesia after surgical treatment is a complex concept that includes not only the level of satisfaction with the anesthesia itself but also the presence of fears, worries, depression, evaluation of the anesthesiologists' work, as well as cognitive dysfunction as a possible negative consequence of anesthesia.

Objective:

Conducting a comprehensive analysis of patients' satisfaction with anesthesia.

Methods:

Questionnaire of patients' satisfaction with anesthesia (Sinbukhova E.V., Lubnin A.Yu.), State-Trait Anxiety Inventory in the adaptation by Y.L. Hanin, Assessment of Depression, The Montreal Cognitive Assessment (MoCA), and Frontal Assessment Battery. Population consisted of 202 patients.

Results:

Satisfaction with anesthesia: assessment “good and higher” with primary anesthesia – 59.7% of patients with repeated – 70% of patients. The most common factors that reduce the assessment of patients' satisfaction with anesthesia are: strong excitement before surgery about operation and anesthesia, no postoperative visit of the anesthesiologist, no visit of the anesthesiologist before the operation, not enough attention of anesthesiologist in the surgery room before anesthesia, nausea, vomiting, pain, dizziness, general discomfort, and thirst. MoCA cognitive assessment before and after anesthesia: P < 2.2 e–16 (significant decrease). Depression: major depression in 52% of patients, subclinical depression in 22.8%.

Conclusion:

Regular survey of patients' satisfaction should help to improve the quality of medical care. The strong excitement of the patient about the upcoming anesthesia and surgery, and the presence of a high level of anxiety and depression can be factors of reducing the patients' satisfaction with anesthesia. It requires psychological support of patients at the stage of surgical treatment.

Satisfaction of surgical patients with perioperative nursing care in a Spanish tertiary care hospital

OBJECTIVE

Although numerous studies have assessed patient satisfaction in diverse settings, in the realm of nursing surgical care, standardization of measurement for patient experience and satisfaction is lacking. Therefore, the aim of this study was to assess the satisfaction of surgical patients with perioperative nursing care.

METHOD

A descriptive cross-sectional survey was conducted. Sociodemographic characteristics and clinical data were recorded. Patient satisfaction was measured with a modified version of the La Monica-Oberst Patient Satisfaction Scale (LOPSS-12).

RESULTS

150 patients (73 women, 49% and 77 men; 51%) completed the survey. The mean age was 63 years (standard deviation, 16 years). The mean overall satisfaction score on the La Monica-Oberst Patient Satisfaction Scale was 3.17 (standard deviation, 0.21). The scale showed adequate content validity (Lawshe's Content Validity Index was 0.76) and moderate reliability (Cronbach's alpha = 0.70). Two variables-patient sex and the presence of comorbidities-were significantly associated with overall satisfaction: men and patients with comorbidities were more satisfied with the care received. Patients with university studies were significantly more likely than patients with less education to consider nurses "impatient," but also considered the nurses' advice to be "useful." Patients with hospital-acquired complications were more likely to perceive nurses to be "more interested in completing tasks than in listening," although they also felt that nurses worked "conscientiously."

CONCLUSION

Overall, patient satisfaction with perioperative nursing care was good. This study identified several areas of nursing care in need of improvement, particularly the need to spend more time with patients and to keep them better informed about the perioperative process. The modified La Monica-Oberst Patient Satisfaction Scale is suitable for measuring surgical patient satisfaction with perioperative nursing care. The findings presented here may be of value to nursing administrators, educators, and nursing care providers to improve patient satisfaction and to develop strategies to prevent patient dissatisfaction.

Expectations and needs of relatives of critically ill patients in the emergency department

Background:

The care of critically ill patients is a strong indicator of service quality provided in the emergency department. Since families are the major social support sources, assessing the family members’ needs may reduce their anxiety and depression owing to the acute situation of their loved ones while improving the patients’ recovery.

Objective:

We aimed to evaluate the expectations and needs of relatives of critically ill patients to formulate solutions to improve the quality of emergency department service.

Methods:

We conducted a prospective, cross-sectional survey of 873 relatives of nontraumatic, critically ill patients who completed the Turkish version of the Critical Care Family Needs Inventory in the emergency department of a university hospital in Turkey. The needs statements were evaluated under five subheadings: meaning, proximity, communication, comfort, and support.

Results:

In total, 249 (28.5%) participants were females and 624 (71.5%) were males (mean age, 41.79 years). The “meaning” category was given the highest priority, followed by “communication,” with average points of 3.75 and 3.57, respectively. The most important needs were being informed regularly about the patient’s condition and being assured that the patient is under the best possible care, whereas personal, physical, and emotional needs were the least important.

Conclusion:

Relatives of critically ill patients primarily focus on the quality of patients’ care. Creating a positive rapport based on trust and providing a healthcare environment where the expectations and needs of relatives are met should be prioritized by emergency department physicians, nurses, and other staff while caring for critically ill patients.

How Long Does It Take for Patients to Complete PROMIS Scores?: An Assessment of PROMIS CAT Questionnaires Administered at an Ambulatory Sports Medicine Clinic

Background:

Challenges exist in routinely collecting patient-reported outcomes (PROs) from patients at a busy ambulatory clinic. A number of validated Patient-Reported Outcomes Measurement Information System (PROMIS) subdomains allow for efficient PRO administration.

Purpose:

To determine the time to completion (TTC) of 3 PROMIS computer adaptive test (CAT) scores. CAT questionnaires were administered at the ambulatory clinic with the following PROMIS subdomains: Pain Interference (PI), Depression, and Physical Function for lower extremity (PF) or for upper extremity (UE). The secondary purpose was to determine the influence of patient demographic factors on TTC.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

Patients were recruited from 3 fellowship-trained upper extremity and sports medicine orthopaedic surgery clinics. PROMIS CAT questionnaires were administered to consecutive patients during the study period (July 2017–September 2017). The start and completion times of each CAT were recorded. The primary outcome of interest was TTC of the questionnaires. Patients were stratified into age quartiles to determine the impact of age on TTC. Patient demographic information, such as sex, race, and ethnicity, was determined retroactively.

Results:

A total of 1178 questionnaire sets consisting of 3658 individual PROMIS forms were analyzed. The mean TTC was 3.29 minutes for all 4 forms in aggregate, with PROMIS PI, PF, UE, and Depression taking on average 1.05, 0.74, 0.96, and 0.57 minutes to complete, respectively. Patients from the oldest age quartile (mean ± SD, 70.3 ± 7.5 years) had a statistically significant longer TTC as compared with the second quartile (41.2 ± 4.7 years) (3.70 vs 2.87 minutes; P < .05). Asian patients had the longest PROMIS PF TTC, while white patients completed PF with the shortest TTC (1.28 vs 0.68 minutes; P < .05). Patients of unstated ethnicity had a longer TTC for PF as compared with their Hispanic/Latino and non-Hispanic/Latino counterparts (0.91 vs 0.30 and 0.70 minutes; P < .05).

Conclusion:

PROMIS CAT forms are efficient tools for collecting patient-reported outcomes in the ambulatory orthopaedic surgery clinic. Older patients, Asian patients, and patients of unstated ethnicity took longer to complete the forms.

Perceived doctor-patient relationship and satisfaction with general practitioner care in older persons in residential homes

OBJECTIVE

Understanding patient satisfaction from the perspective of older adults is important to improve quality of their care. Since patient and care variables which can be influenced are of specific interest, this study examines the relation between patient satisfaction and the perceived doctor-patient relationship in older persons and their general practitioners (GPs).

DESIGN

Cross-sectional survey.

SUBJECTS AND SETTING

Older persons (n = 653, median age 87 years; 69.4% female) living in 41 residential homes.

MAIN OUTCOME MEASURES

Patient satisfaction (report mark) and perceived doctor-patient relationship (Leiden Perioperative care Patient Satisfaction questionnaire); relationships were examined by comparing medians and use of regression models.

RESULTS

The median satisfaction score was 8 (interquartile range 7.5-9; range 0-10) and doctor-patient relationship 65 (interquartile range 63-65; range 13-65). Higher satisfaction scores were related to higher scores on doctor-patient relationship (Jonckheere Terpstra test, p for trend <.001) independent of gender, age, duration of stay in the residential home, functional and clinical characteristics. Adjusted for these characteristics, per additional point for doctor-patient relationship, satisfaction increased with 0.103 points (β = 0.103, 95% CI 0.092-0.114; p < .001). In those with a 'low' doctor-patient relationship rating, the percentage awarding 'sufficient or good' to their GP for 'understanding about the personal situation' was 12%, 'receiving attention as an individual' 22%, treating the patient kindly 78%, and being polite 94%.

CONCLUSION

In older persons, perceived doctor-patient relationship and patient satisfaction are related, irrespective of patient characteristics. GPs may improve patient satisfaction by focusing more on the affective aspects of the doctor-patient relationship. Key Points Examination of the perceived doctor-patient relationship as a variable might better accommodate patients' expectations and improve satisfaction with the provided primary care.

Slack resources and quality performance: case of a mega health care organization

Purpose

Prior studies have examined the relationship between budgetary slack and short-termism of management within a profit-seeking business environment. The purpose of this paper is to examine the dynamics of slack resources in relation to quality performance of heath care services delivered by a publicly funded organization.

Design/methodology/approach

A longitudinal regression analysis of resource utilization, productivity and the quality of health care services delivered is performed to reveal evidence about the underlying dynamics of heterogeneous slack resources. It attempts to study slack resources in the case of a “mega” health care service provider based in Hong Kong.

Findings

The results suggest that the organization’s cost containment culture, with a strategic focus on productivity measures, has augmented cost effectiveness; however, not all slack resources would enhance quality performance.

Originality/value

This study of a mega health care service provider complements the prior studies of slack resources and points out the challenges of proactively managing any slack resources toward quality performance beyond productivity.

A matter of perspective - Objective versus subjective outcomes in the assessment of quality of recovery

Current post-operative recovery assessment exists as a dichotomy, maintaining objectivity whilst providing relevance to patient-centred care. Both objective and subjective measures are utilised in modern recovery assessment and are best viewed as complimentary. At institutional and provider levels, performance indicators are utilised as surrogates for quality of recovery but only if these indicators are assessed in the clinical context from which they are derived. Patient-reported outcomes prioritise the patient's perspective of symptoms and care, which are the most important aspects at the time of assessment but are limited by their susceptibility to response shift and recall bias. Ideally, quality of recovery is assessed using objective measures in concert with measures of clinical complexity and in parallel with patient-reported outcomes.

Patient satisfaction and experience with anesthesia: A multicenter survey in Saudi population

BACKGROUND AND OBJECTIVES

Patients' satisfaction of anesthesia outcomes is a major part of the overall quality of health care. The aim of this study is to evaluate patient's satisfaction whether pre- or post-operative as well as overall impression using a multicenter prespecified survey tool.

METHODS

Three hundred and three patients who underwent surgery regardless the type of anesthesia were surveyed. The interview conducted face-to-face before surgery then within the first 24 h of surgery. We recorded all basic demographics of patients, the quality of postoperative symptoms control, and the impression about anesthesia team.

RESULTS

The overall satisfaction level was moderate (56.5%) with nearly half of the patients dissatisfied with their anesthetic care due to different reasons. Nausea and vomiting control was the most common postoperative reasons for dissatisfaction followed by pain control with 35.6% and 31.7%, respectively.

CONCLUSION

Type of anesthesia, giving an informative visit to the patient, and the control of postoperative symptoms are the most important predictors of patients' satisfaction.

The role of job satisfaction, work engagement, self-efficacy and agentic capacities on nurses' turnover intention and patient satisfaction

BACKGROUND

Nurses' voluntary turnover is a worrying global phenomenon which affects service quality. Retaining nursing staff within a hospital is important to eliminate the negative influence of voluntary turnover on the quality of care and organisation costs.

OBJECTIVES

This research helps explain nurses' voluntary turnover by analysing the role of self-efficacy, agentic capacities, job satisfaction, and work engagement on hospital turnover intention, and to study the relationships between these variables and patient satisfaction.

SETTING AND PARTICIPANTS

This study gathered data from 194 nurses and 181 patients from 22 inpatient wards at two hospitals in southern Italy.

RESULTS

Correlation analysis revealed that job satisfaction, work engagement, self-efficacy and agentic capacities were positively interrelated and negatively correlated with turnover intention. Path analysis showed that self-efficacy, some agentic capacities (anticipation and self-regulation), job satisfaction, and work engagement had direct or indirect effects on nurses' turnover intention, and that job satisfaction exerted a stronger effect on turnover intention. Also, patient satisfaction was positively correlated with nurses' job satisfaction, work engagement, self-efficacy, self-regulation and anticipation and negatively correlated with nurses' turnover intention.

CONCLUSION

Results highlighted the importance of implementing actions (for example through feedforward methodology and the goal setting technique) to improve self-efficacy, self-regulation skill, work engagement and job satisfaction in order to reduce nurses' turnover intention and increase patient satisfaction with nursing care.

Patient satisfaction in out-of-hospital emergency care: a multicentre survey

BACKGROUND

There is only limited information on patient satisfaction with emergency medical services (EMS). The aim of this multicentre survey was to evaluate patient satisfaction in five out-of-hospital physician-based EMS in Austria and Switzerland.

METHODS

The psychometrically tested and standardized questionnaire 'patient satisfaction in out-of-hospital emergency care' was used for this survey. The recruitment of the patients was carried out on the basis of inclusion and exclusion criteria. All questionnaires were sent together with an invitation letter and a prepaid return envelope, followed by a reminder 2 weeks later. The descriptive statistical analysis was carried out by an external organization to maintain anonymity.

RESULTS

The response rate of all EMS was 46.7%. High satisfaction rates were achieved for the four quality scales 'emergency call, emergency treatment, transport and hospital admission'. A significant difference was found between the Swiss and the Austrian dispatch centres in the judgement of the call takers' social skills. Patient satisfaction with the emergency treatment, for example, reduction of pain, was high in all EMS, independent of whether the EMS is physician (Austria) or physician and emergency medical assistant based (Switzerland). Lowest satisfaction rates were found for items of social skills.

CONCLUSION

Patient satisfaction in out-of-hospital physician-based EMS is generally high. There is room for improvement in areas such as the social skills of dispatchers and EMS-team members and the comfort of the patients during transport. A checklist should be developed for basic articles that patients should take along to hospital and for questions on responsibilities for children, dependent people or pets.

First steps in validating the pediatric anesthesia parent satisfaction (PAPS) survey

BACKGROUND

In the last few decades, patient satisfaction has become a critical component of quality assessment and is being incorporated into payment for performance plans. However, assessment of satisfaction with anesthesia services is problematic and few validated satisfaction tools have been published. Assessing parent satisfaction with pediatric anesthesia services is even more challenging.

OBJECTIVE

Our aim was to develop, implement, and start validating a set of survey questions that evaluate parental satisfaction with the pediatric anesthesia services in order to identify strengths and potential areas for improvement.

METHODS

The Pediatric Anesthesia Parent Satisfaction (PAPS) survey contained 17 questions adapted from the American Society of Anesthesiologists Committee on Outcomes and Performance Measures. With consent of the hospital quality improvement committee, the PAPS survey was randomly administered on iPads to 250 English-speaking parents in the main operating room and procedure center postanesthesia care units prior to discharge. Statistical analyses including descriptive statistics, exploratory factor analysis, Cronbach's alpha and Raykov's rho coefficients, composite scale creation, correlations between items, composite scores, and overall satisfaction measures were used to provide evidence for a subset of validity and reliability types.

RESULTS AND CONCLUSIONS

The PAPS survey is a short and simple tool for evaluation of parent satisfaction with pediatric anesthesia services and provides some evidence for validity and reliability. The majority (greater than 95%) of parents reported were satisfied or very satisfied with the care provided by the pediatric anesthesia department.

Racial/ethnic variation in health care satisfaction: The role of acculturation

This study examined the role of acculturation and racial/ethnic variation in health care satisfaction among four different racial/ethnic groups. The study sample consisted of 41,560 adults from the 2011 California Health Interview Survey. Health care satisfaction was measured via two questions regarding doctors' listening and explanations. Guided by Andersen's behavioral model of health care use, multivariate logistic regressions were conducted. Hispanic and Asian respondents showed the lowest levels of satisfaction with their doctors' listening and explanations, respectively. Acculturation was found to be a significant predictor of health care satisfaction. Health care professionals should develop ways of expanding culturally competent health care professionals, who are aware of racial/ethnic variation in health care satisfaction.

Perception of service satisfaction and quality of life of patients living with schizophrenia in Lagos, Nigeria

OBJECTIVE

To assess service-satisfaction and quality of life among patients with schizophrenia in a tertiary psychiatric healthcare facility in Lagos, Nigeria.

METHODS

Cross-sectional survey of 101 (out of 120) patients diagnosed with schizophrenia attending the outpatient clinic of the Federal Neuro-Psychiatric Hospital Yaba, Lagos, Nigeria. The Structured Clinical Interview for DSM-IV diagnosis (SCID), Charleston Psychiatric Out-patient Scale (CPOSS), and the World-Health Organisation Quality of Life -Bref scale (WHOQOL-BREF) was used in assessing diagnosis, patient satisfaction and subjective quality of life respectively.

RESULTS

The ages of the patient ranged from 19-81. Males (49.5%) and females (50.5%) had almost equal distribution. Mean duration of attendance was 8.7years ± 8.50. Service satisfaction ranged between 25-60 on the CPOSS. Areas that had higher mean scores on CPOSS were with items (1) Helpfulness of the records clerk (3.70±1.1), (7) Helpfulness of services received (3.69±1.0). Subjective quality of life was high (3.65±1.8), satisfaction with health was also high (3.40±1.1). Service satisfaction correlated with Quality of life at P < 0.00.

The effect of patient qualifications and number of patient accompanist on patient's satisfaction

Objectives

Patient satisfaction surveys are important information sources for the evaluation of the quality and continuity of medical care. In this study, it is aimed to investigate the impact of patient's qualifications and the number of patient accompanists on the patient satisfaction and to find out whether there is a relationship between the number of patient accompanist and discharge status of patient.

Methods

All patients over 18 years old who have applied to emergency department within one month, along with the relevant patient information were recorded. The patients and patient accompanists were asked questions by an unrelated staff after the patient was discharged.

Results

The average of patients (n = 264) satisfied with emergency department is 100 ± 0.9 (%95CI 88.4–92.3). It was observed that the patient satisfaction is directly proportional to the age and inversely proportional to the educational level (r = 0.241, p = 0.0001, r = −0.236 p = 0.0001; respectively). It was found out that the patients who were male, hospitalized and had ≥2 accompanists were statically more satisfied (p = 0.002), however; there was no relationship between the patient satisfaction and the complaints and the presence of an accompanist (p = 0.408).

Conclusions

It was determined that the satisfaction levels of the patients and their accompanist were high. Parameters such as male gender, age over 65 and living with the family increase patient satisfaction. Satisfaction of the patient accompanists increases if the patient is female and hospitalized. High education level decreases the level of patient satisfaction.

Conceptualisation of patient satisfaction: a systematic narrative literature review

Aim:

Patient satisfaction concept is widely measured due to its appropriateness to health service; however, evidence suggests that it is a poorly developed concept. This article is a first part of a two-part series of research with a goal to review a current conceptual framework of patient satisfaction and to bring the concept for further operationalisation procedures. The current article aimed to review a theoretical framework that helps the next article to review determinants of patient satisfaction for designing a measurement system.

Method:

The study used a systematic review method, meta-narrative review, based on the RAMESES guideline with the phases of screening evidence, appraisal evidence, data extraction and synthesis. Patient satisfaction theoretical articles were searched on the two databases MEDLINE and CINAHL. Inclusion criteria were articles published between 1980 and 2014, and English language papers only. There were 36 articles selected for the synthesis.

Results:

Results showed that most of the patient satisfaction theories and formulations are based on marketing theories and defined as how well health service fulfils patient expectations. However, review demonstrated that a relationship between expectation and satisfaction is unclear and the concept expectation itself is not distinctly theorised as well.

Conclusions:

Researchers brought satisfaction theories from other fields to the current healthcare literature without much adaptation. Thus, there is a need to attempt to define the patient satisfaction concept from other perspectives or to learn how patients evaluate the care rather than struggling to describe it by consumerist theories.

Psychometric Testing of a Comprehensive Patient Satisfaction Survey in Arabic

Background and Purpose: Although patient satisfaction is an important indicator of the quality of care received in hospitals, no reliable and valid Arabic comprehensive inpatient satisfaction survey has been published. The purpose of this study was to evaluate the psychometric properties of an Arabic patient satisfaction survey. Methods: A cross-sectional design was used where 1,339 randomly selected patients were interviewed by phone. The questionnaire was adopted and from the Hospital Consumer Assessment of Healthcare Providers and Systems survey, refined and tested over a 4-year period. Results: Item–item correlations for the 22 items on the survey ranged from .52 to .92, and the Cronbach’s alpha coefficient was .87. Construct and predictive validity were also adequate. Conclusion: The survey is recommended for use in hospitals in Lebanon and other Middle Eastern countries to facilitate benchmarking and quality improvement.

Designing questionnaires: healthcare survey to compare two different response scales

BACKGROUND

A widely discussed design issue in patient satisfaction questionnaires is the optimal length and labelling of the answering scale. The aim of the present study was to compare intra-individually the answers on two response scales to five general questions evaluating patients' perception of hospital care.

METHODS

Between November 2011 and January 2012, all in-hospital patients at a Swiss University Hospital received a patient satisfaction questionnaire on an adjectival scale with three to four labelled categories (LS) and five redundant questions displayed on an 11-point end-anchored numeric scale (NS). The scales were compared concerning ceiling effect, internal consistency (Cronbach's alpha), individual item answers (Spearman's rank correlation), and concerning overall satisfaction by calculating an overall percentage score (sum of all answers related to the maximum possible sum).

RESULTS

The response rate was 41% (2957/7158), of which 2400 (81%) completely filled out all questions. Baseline characteristics of the responders and non-responders were similar. Floor and ceiling effect were high on both response scales, but more pronounced on the LS than on the NS. Cronbach's alpha was higher on the NS than on the LS. There was a strong individual item correlation between both answering scales in questions regarding the intent to return, quality of treatment and the judgement whether the patient was treated with respect and dignity, but a lower correlation concerning satisfactory information transfer by physicians or nurses, where only three categories were available in the LS. The overall percentage score showed a comparable distribution, but with a wider spread of lower satisfaction in the NS.

CONCLUSIONS

Since the longer scale did not substantially reduce the ceiling effect, the type of questions rather than the type of answering scale could be addressed with a focus on specific questions about concrete situations instead of general questions. Moreover, the low correlation in questions about information provision suggests that only three possible response choices are insufficient. Further investigations are needed to find a more sensitive scale discriminating high-end ratings. Otherwise, a longitudinal within-hospital or a cross-sectional between-hospital comparison of patient care is questionable.

An Analysis of Methodologies That Can Be Used to Validate if a Perioperative Surgical Home Improves the Patient-centeredness, Evidence-based Practice, Quality, Safety, and Value of Patient Care

Approximately 80 million inpatient and outpatient surgeries are performed annually in the United States. Widely variable and fragmented perioperative care exposes these surgical patients to lapses in expected standard of care, increases the chance for operational mistakes and accidents, results in unnecessary and potentially detrimental care, needlessly drives up costs, and adversely affects the patient healthcare experience. The American Society of Anesthesiologists and other stakeholders have proposed a more comprehensive model of perioperative care, the Perioperative Surgical Home (PSH), to improve current care of surgical patients and to meet the future demands of increased volume, quality standards, and patient-centered care. To justify implementation of this new healthcare delivery model to surgical colleagues, administrators, and patients and maintain the integrity of evidenced-based practice, the nascent PSH model must be rigorously evaluated. This special article proposes comparative effectiveness research aims or objectives and an optimal study design for the novel PSH model.