Factors Associated With Patient Satisfaction in Outpatient Department of Suva Sub-divisional Health Center, Fiji, 2018: A Mixed Method Study

Mental health service satisfaction among adults with mental illness attending a psychiatric outpatient clinic: a cross-sectional study

Background

Patient satisfaction with services is both a direct and indirect indicator of healthcare quality. It influences healthcare outcomes, patient retention, and the likelihood of medical malpractice claims. However, there is limited evidence on patient satisfaction with mental health services in Africa. Therefore, we aimed to assess mental health service satisfaction and its determinants in adult patients with mental illness in an outpatient clinic in Northwest Ethiopia.

Methods

A hospital-based cross-sectional study was conducted from October to March 2023. Participants were selected using systematic random sampling with a sample interval of three, resulting in a total sample size of 638 invited to participate. Service satisfaction was measured using the interviewer-administered Client Satisfaction Questionnaire-8 (CSQ-8). Data entry, coding, and analysis were performed using SPSS-28. To examine the association of sociodemographic, clinical, social support, and substance use factors, bivariate and multivariate logistic regression analyses were applied. Statistical significance was declared at a p-value of <0.05 and 95% CI.

Results

The rate of low mental health service satisfaction among people with mental illness in this study was 24.7%. According to our multivariate logistic regression analysis, people with urban residence 1.77 (1.15, 2.72), poor self-reported health 3.62(1.97, 6.67), having episodic illness ≥2/yr. 0.48 (0.32, 0.74), having relapse 1.75 (1.12, 2.73), and poor drug adherence 2.28 (1.20, 4.35) were more likely to have low mental health service satisfaction than their counterparts.

Conclusions and recommendation

One-quarter of patients with mental illness in the outpatient clinic reported low satisfaction with mental health services. Factors associated with lower satisfaction included urban residency, episodic illness, relapse, poor self-reported health, and poor drug adherence. To enhance patient satisfaction, the clinic should prioritize targeted support for patients facing these challenges.

Ethnic disparities in perceived racism, patient-provider communication and healthcare utilization: Asian Americans

BACKGROUND

Race is a consequential sociocultural cue in healthcare contexts. Racism is associated with health disparities by influencing patient-provider communication and utilization of healthcare services.

OBJECTIVE

This study aimed to investigate how Asian American subgroups differ in their perception of everyday racism, internalized racism, and perceived racism in healthcare settings and whether these perceptions predict their interactions with their health care providers and their utilization of healthcare services.

METHODS

An online survey study was conducted. ANOVA tests were employed to compare the differences in perceptions of everyday racism, internalized racism, and perceived racism in the healthcare system among Filipino (N = 310), Japanese (N = 242), Chinese (N = 287), Asian Indian (N = 304), Korean (N = 199) and Vietnamese (N = 151) participants. Multiple regression analyses assessed whether perceptions of everyday racism, internalized racism, and perceived racism in the healthcare system predicted healthcare service utilization and patient-provider communication among the Asian subgroups sampled.

RESULTS

There were significant group differences in perceived everyday racism (F = 8.56, p < .001), internalized racism (F = 3.46, p < .01), perceived racism in healthcare (F = 4.57, p < .001). Perceptions of racism and socioeconomic variables were found to predict patient-provider communication and utilization of healthcare services disparately across various Asian subgroups. For instance, the perception of everyday racism was a significant predictor of patient-provider communication for each of the subgroups, excluding the Vietnamese participants. Internalized racism was a significant predictor only for Filipino and Chinese participants. Surprisingly, perceived racism in healthcare was not a predictor for any of the subgroups.

CONCLUSION

Findings highlight the complex interplay of sociodemographic factors and perceived racism in shaping patient-provider communication and healthcare service utilization within the Asian American community. Implications are suggested for addressing the unique challenges faced by different Asian American subgroups and for promoting equitable healthcare access and fostering positive patient-provider relationships among the Asian American subgroups.

Outcomes of Age-Friendly Health Systems: Return to Clinic After 4Ms Care Delivery

The Age-Friendly Health System (AFHS) movement continues to grow in the United States as more health systems implement the 4Ms framework. Despite this growth, there are relatively few studies that evaluate outcomes related to AFHS implementation. This study assessed patient satisfaction with AFHS by analyzing the rate at which patients returned to the clinic for future health care, serving as a measure of quality. A retrospective cohort design using electronic health record (EHR) data obtained from patients 65 years of age and older who received care at a large national network of convenient care clinics in the U.S. (N = 987,197) between January 2021 and March 2024. We assessed the level of AFHS 4Ms care received by these individuals in relation to their subsequent visit back to the clinic through descriptive statistics, a time-to-event analysis using the Kaplan-Meier cumulative incidence approach, and a Cox proportional Hazards model, adjusted for age, race, sex, prior appointments, and number of ICD-10 code diagnoses. Throughout the study period, patients who received complete AFHS 4Ms care exhibited greater rates of returning to the convenient care clinic compared to those who received partial or no 4Ms 4Ms care. Kaplan-Meier curves demonstrated that the cumulative probability of returning to the clinic was higher in patients that received 4Ms over time, compared to patients that did not receive 4Ms. Results from the Cox Proportional Hazards model demonstrated a risk ratio of 3.91 (p < .001) of returning to the clinic, after adjustment. The results indicate that patients are more likely to seek additional care in the future at the same health system when they receive complete 4Ms care, possibly due to increased satisfaction with care. As patient satisfaction is an indicator of quality care, this finding can further inform and spread the AFHS movement.

Age as a Moderator of Health Outcomes and Trust in Physicians

Objectives: Patient trust in physicians is associated with patient satisfaction with healthcare, patients engaging in follow-up care, and positive health-related outcomes. The current study investigated whether age moderated the relation between trust in physicians and four health outcome variables, including patient satisfaction, doctor visits, emergency room visits, and hospital admissions. Methods: 398 English-speaking, community-dwelling adults completed measures of physician trust and important health outcome variables via Amazon Mechanical Turk. Results: Age significantly moderated relations between trust in physicians and hospital admissions, and trust in physicians and patient satisfaction, with both positive relations becoming stronger with increasing age. Discussion: The results highlight the need for a lifespan approach to the study of physician trust and related health outcomes. They offer an avenue for increasing physician trust, engagement with the healthcare system prior to the need for hospitalization, and the reduction of healthcare costs.

Impact of patient-centered communication on patient satisfaction scores in patients with chronic life-limiting illnesses: an experience from Kenya

Background

Patient satisfaction remains a key area of interest worldwide; utilizing a patient-centered communication approach, particularly with patients with chronic life-limiting illnesses may be one way to achieve this. However, there is a dearth of empirical information on the effect of patient-centered communication strategies in patients with chronic life-limiting illnesses in Kenya on patient satisfaction.

Objectives

The objective of this study was to assess the impact of patient-centered communication on patient satisfaction.

Methods

We conducted our study at a tertiary teaching and referral hospital in Kenya. We utilized a quasi-experimental pre-test post-test study design and engaged 301 adult medical in-patients with chronic life limiting conditions. We randomized them to receive patient-centered communication, and evaluated the change in patient satisfaction scores using an adapted Medical Interview satisfaction Scale 21 (MISS 21).

Results

Two hundred and seventy-eight out of 301 recruited participants completed the study. The baseline characteristics of the participants randomized to the control and intervention arms were similar. Although both the control and intervention arms had a decline in the mean difference scores, the intervention arm recorded a larger decline, -15.04 (-20.6, -9.47) compared to -7.87 (-13.63, -2.12), with a statistically significant mean difference between the two groups at -7.16 (-9.67, -4.46). Participants in the intervention arm were less likely to: understand the cause of their illness (p < 0.001), understand aspects of their illness (p < 0.001), understand the management plan (p < 0.001), receive all the relevant information on their health (p < 0.001), and to receive adequate self-care information (p < 0.001). They were also less likely to acknowledge a good interpersonal relationship with the healthcare providers (p < 0.001), to feel comfortable discussing private issues (p < 0.004), and to feel that the consultation time was adequate (p < 0.001).

Conclusion and recommendation

Contrary to expectation, patient-centered communication did not result in improved patient satisfaction scores. Further studies can evaluate factors affecting and explaining this relationship and assess intermediate and long-term effects of provision of a patient-centered communication in diverse global contexts.

Pregnant women's satisfaction with the quality of antenatal care and the continued willingness to use health facility care in Lusaka district, Zambia

BACKGROUND

Antenatal healthcare (ANC) reduces maternal and neonatal deaths in low-middle-income countries. Satisfaction with ANC services and perception of quality of care are critical determinants of service utilization. The study aimed to assess pregnant women's satisfaction with ANC and identify sociodemographic factors associated with satisfaction and their continued willingness to use or recommend the facility to relatives or friends, in Lusaka district, Zambia.

METHODS

This was a cross-sectional study involving 499 pregnant women in Lusaka district. A combination of stratified, multistage, and systematic sampling procedures was used in selecting health facilities and pregnant women. This allowed the researcher to assess exposure and status simultaneously among individuals of interest in a population. Structured survey instruments and face-face-interview techniques were used in collecting data among pregnant women who were receiving ANC in selected health facilities.

RESULTS

Overall, the proportion of pregnant women who were fully satisfied with ANC was 58.9% (n = 292). Pregnant women's satisfaction score ranged from physical aspects (40.9 - 58.3%), interpersonal aspects (54.3 - 57.9%) to technical aspects of care (46.9 - 58.7%). Husbands' employment status (OR = 0.611, 95%CI = 0.413 - 0.903, p = 0.013), monthly household income level of > 3000 - ≤6000 Kwacha (OR = 0.480, 95%CI = 0.243 - 0.948, p = 0.035 were significantly associated with the interpersonal aspects and the physical aspects of care, respectively. Besides, pregnant women who were in their third trimester (above 33 weeks), significantly predicted satisfaction with the physical environment of antenatal care (OR = 3.932, 95%CI = 1.349 - 11.466, p = 0.012). In terms of the type of health facility, women who utilized ANC from Mtendere (OR = 0.236, 95% CI = 0.093 - 0.595, p = 0.002) and N'gombe (OR = 0.179, 95% CI = 0.064 - 0.504, p = 0.001) clinics were less satisfied with the physical environment of care. Place of residence and educational attainment showed significant association with 'willingness to return'. N'gombe clinic (n = 48, 77.4%) received the lowest consideration for 'future care'.

CONCLUSION

Drawing on Donabedian framework on assessing quality of healthcare, we posit that pregnant women's satisfaction with the quality of antenatal care was low due to concerns about the physical environment of health facilities, the interpersonal relationships between providers and pregnant women as well as the technical aspects of care. All these accounted for pregnant women's dissatisfaction with the quality of care, and the indication of unwillingness to return or recommend the health facilities to colleagues. Consistent with Donabedian framework, we suggest that the codes and ethics of healthcare must be upheld. We also call for policy initiatives to reshape the physical condition of ANC clinics and to reinforce healthcare providers' focus on the 'structures' and the 'processes' relevant to care in addition to the 'outcomes'.

How satisfied are patients with nursing care and why? A comprehensive study based on social media and opinion mining

To assess the overall experience of a patient in a hospital, many factors must be analyzed; nonetheless, one of the key aspects is the performance of nurses as they closely interact with patients on many occasions. Nurses carry out many tasks that could be assessed to understand the patient's satisfaction and consequently, the effectiveness of the offered services. To assess their performance, traditionally, expensive, and time-consuming methods such as questionnaires and interviews have been used; nevertheless, the development of social networks has allowed the patients to convey their opinions in a free and public manner. For that reason, in this study, a comprehensive analysis has been performed based on patients' opinions collected from a feedback platform for health and care services, to discover the topics about nurses the patients are more interested in. To do so, a topic modeling technique has been proposed. After this, sentiment analysis has been applied to classify the topics as satisfactory or unsatisfactory. Finally, the results have been compared with what the patients think about doctors. The results highlight what topics are most relevant to assess the patient satisfaction and to what extent. The results remark that the opinion about nurses is, in general, more positive than about doctors.

Comparative Analysis of Patient Satisfaction Surveys-A Crucial Role in Raising the Standard of Healthcare Services

(1) Background: The study aimed to assess the patients' perception of the quality of the medical staff's care, the hotel's services, and the hospital's overall impression as well as to determine the best rating scale through a comparative analysis of patient satisfaction questionnaires. (2) Methods: A retrospective study was performed based on satisfaction questionnaires addressed to the patients hospitalized in the Orthopedics and Traumatology departments of the County Clinical Emergency Hospital Oradea between 2015 and 2019. Three different types of questionnaires were used during the study period, with the number of questions varying between 30 (variant A) and 37 (variant C). The evaluation was done using the Likert scales with three, four, or five answer variables. (3) Results: The items that we found to be present in all three categories of surveys and for which at least two different questionnaire variants used the Likert scales with various answer variables were chosen. In terms of the treatment given by the medical staff, hotel services, and the overall perception of the hospital, the patients perceive a higher level of quality. (4) Conclusions: The level of patient overall satisfaction or general impression about the hospital is strongly dependent on the quality of medical care provided by the doctors and the specific hotel conditions of the hospital. The quality assessment using the Likert rating scale with five binary variables is more accurate.

Factors affecting patient satisfaction at a plastic surgery outpatient department at a tertiary centre in South Africa

BACKGROUND

The main purpose of a medical facility is to improve the welfare of patients, and user satisfaction is one of its primary goals. This study aimed to identify variables influencing patient satisfaction at the Plastic Surgery Outpatient Department of Chris Hani Baragwanath Academic Hospital, Gauteng, South Africa. By identifying factors affecting patient satisfaction, the services provided to patients may be improved.

METHODS

A questionnaire was compiled focusing on patients over 18 years of age and using a Likert scale to measure factors influencing patients' satisfaction with the services received. Descriptive statistics were applied.

RESULTS

A total of 142 participants, 69% of whom were under age 40 and 52.8% were male, were recruited using a systematic sampling technique. In 78% of cases, this was the patient's first visit to the clinic. The results revealed that the patients were not satisfied with the ease of appointment scheduling and waiting times. A high level of satisfaction was reported for both nursing staff and doctors, aside from a lack of clear and prominent display of name badges. Overall satisfaction was at the "satisfied" level, and no participants reported lower than neutral feelings. The CSAT score was 79.5%, which is considered "good" for healthcare. The participant's level of education was significant in multiple items; those with the lowest education reported higher overall satisfaction. A model produced by regression analysis was found to be strongly significant statistically.

DISCUSSION

Batho Pele principles in South Africa provide a framework for consulting with service consumers, ascertaining their happiness, and identifying methods to enhance their experience. According to this survey, people are happy with the human part of the services received, although areas such as scheduling appointments and the physical surroundings still need much work.

CONCLUSION

These aspects of treatment are occasionally disregarded in a medical organisation with insufficient finances. Developing these areas can help turn patients into devoted patrons of a healthcare facility. An effective strategy to boost customer satisfaction has been suggested to enhance service quality and, especially in South Africa, conform to Batho Pele service standards.

Quality communication can improve patient-centred health outcomes among older patients: a rapid review

BACKGROUND

Effective communication is a cornerstone of quality healthcare. Communication helps providers bond with patients, forming therapeutic relationships that benefit patient-centred outcomes. The information exchanged between the provider and patient can help in medical decision-making, such as better self-management. This rapid review investigated the effects of quality and effective communication on patient-centred outcomes among older patients.

METHODS

Google Scholar, PubMed, Scopus, CINAHL, and PsycINFO were searched using keywords like "effective communication," "elderly," and "well-being." Studies published between 2000 and 2023 describing or investigating communication strategies between older patients (65 years and above) and providers in various healthcare settings were considered for selection. The quality of selected studies was assessed using the GRADE Tool.

RESULTS

The search strategy yielded seven studies. Five studies were qualitative (two phenomenological study, one ethnography, and two grounded theory studies), one was a cross-sectional observational study, and one was an experimental study. The studies investigated the effects of verbal and nonverbal communication strategies between patients and providers on various patient-centred outcomes, such as patient satisfaction, quality of care, quality of life, and physical and mental health. All the studies reported that various verbal and non-verbal communication strategies positively impacted all patient-centred outcomes.

CONCLUSION

Although the selected studies supported the positive impact of effective communication with older adults on patient-centred outcomes, they had various methodological setbacks that need to be bridged in the future. Future studies should utilize experimental approaches, generalizable samples, and specific effect size estimates.

Women's Expectations of and Satisfaction with Antenatal Care Services in a Semi-Urban Setting in Tanzania and Associated Factors: A Cross-Sectional Survey

Women's satisfaction has been found to be a good indicator of quality of care and is associated with the utilization of healthcare services. Women's needs and satisfaction could be improved through the provision of high-quality antenatal care services. This study assessed women's expectations of and satisfaction with antenatal care and their associated factors in a semiurban setting in Tanzania. A cross-sectional survey using the Expectations and Satisfaction with the Prenatal Care Questionnaire (PESPC) was used to measure pregnant women's expectations of and satisfaction with antenatal care in the two districts of Kibaha and Bagamoyo, involving 338 pregnant women. The data were analyzed using SPSS version 26. In the expectation subscale, women had high expectations for personalized care (78.4%), other services (from a social worker and nutritionist) (68.8%), and complete care (being taken care of on time, receiving excellent care, and receiving information without prompting) (60.9%), while expectations for continuity of care were the lowest (38.9%). In the satisfaction subscale, women were highly satisfied with providers' care (being cared for with respect, healthcare provision, the way they were made to feel, and the ability to ask questions) (88.9%), while the least satisfying aspect was system characteristics (e.g., waiting times, scheduling, parking, tests and examinations, and facilities) (63.4%). Distance from a health facility was a significant predictor of both women's expectations of and satisfaction with antenatal care services, while age and number of pregnancies were also significant predictors of antenatal care expectations. To meet expectations for quality antenatal care services and improve satisfaction with antenatal care, policymakers should improve system characteristics, including the availability of human resources and medical supplies, increased consultation time, flexible schedules, and reduced waiting time. Additionally, ensuring the accessibility of evidence-based health information is important for increasing health literacy among pregnant women.

Treatment expectation among patients with diabetes and hypertension in a tertiary hospital, Ekiti State, Southwest Nigeria: a cross-sectional study

Introduction

patients' satisfaction is an important aspect in determining the quality of health care since it reveals how staff are progressing toward the patients' objectives.Objective: the study determined the treatment perception and expectations among diabetes and hypertensive patients in a teaching hospital in Ekiti State, Nigeria.

Methods

the study employed a cross-sectional design approach with a sample size of 200 participants. Descriptive analyses were used to answer the research questions while inferential statistics were used to test hypotheses at a significant level of p < 0.05.

Results

the findings revealed that 50% (n=196) and 57.1% (n=196) of the patients with diabetes and hypertension were above 60 years with mean age and standard deviation being 3.36 ± 0.72, while 63.3% (n=196) and 64.3% (n=196) of the patients with diabetes and hypertension were females. Overall, the results revealed a significant difference between the domains of participants´ expectations and perceptions, with the expectations domains being significantly higher for both diabetes and hypertensive patients with mean score and standard deviation being (-5.14 (±1.62) and -4.55 (±1.83)) respectively. However, the difference in the gap scores between the participants with diabetes and those with hypertension across the domains of patients´ expectations and perceptions was significant. Furthermore, apart from the tangible domain 19.76 (±0.87) (p < 0.05), the findings from the study showed that participants with diabetes had significantly higher expectation scores, when compared with those with hypertension in all domains. Additionally, the participants with diabetes showed the highest level of perception in the tangible 15.75 (±1.43) and empathy 20.50 (±1.20) domains while those with hypertension showed the highest level of perception in the reliability, responsiveness, and assurance domains (21.66 (±2.45), 16.58 (±1.38) and 21.43 (±2.03) p < 0.001 respectively).

Conclusion

efforts should be intensified by nurses and all other stakeholders to exceed patients´ expectations by continually improving the quality of health care and services offered to patients.

Patient preferences as human factors for health data recommender systems and shared decision making in orthopaedic practice

Background

A core set of requirements for designing AI-based Health Recommender Systems (HRS) is a thorough understanding of human factors in a decision-making process. Patient preferences regarding treatment outcomes can be one important human factor. For orthopaedic medicine, limited communication may occur between a patient and a provider during the short duration of a clinical visit, limiting the opportunity for the patient to express treatment outcome preferences (TOP). This may occur despite patient preferences having a significant impact on achieving patient satisfaction, shared decision making and treatment success. Inclusion of patient preferences during patient intake and/or during the early phases of patient contact and information gathering can lead to better treatment recommendations.

Aim

We aim to explore patient treatment outcome preferences as significant human factors in treatment decision making in orthopedics. The goal of this research is to design, build, and test an app that collects baseline TOPs across orthopaedic outcomes and reports this information to providers during a clinical visit. This data may also be used to inform the design of HRSs for orthopaedic treatment decision making.

Methods

We created a mobile app to collect TOPs using a direct weighting (DW) technique. We used a mixed methods approach to pilot test the app with 23 first-time orthopaedic visit patients presenting with joint pain and/or function deficiency by presenting the app for utilization and conducting qualitative interviews and quantitative surveys post utilization.

Results

The study validated five core TOP domains, with most users dividing their 100-point DW allocation across 1-3 domains. The tool received moderate to high usability scores. Thematic analysis of patient interviews provides insights into TOPs that are important to patients, how they can be communicated effectively, and incorporated into a clinical visit with meaningful patient-provider communication that leads to shared decision making.

Conclusion

Patient TOPs may be important human factors to consider in determining treatment options that may be helpful for automating patient treatment recommendations. We conclude that inclusion of patient TOPs to inform the design of HRSs results in creating more robust patient treatment profiles in the EHR thus enhancing opportunities for treatment recommendations and future AI applications.

Development of a carpark cardiac implantable electronic device clinic to improve time efficiency and patient satisfaction in the context of restrictions imposed by the COVID-19 pandemic

INTRODUCTION

We evaluated time efficiency and patient satisfaction of a "car park clinic" (CPC) compared to traditional face-to-face (F2F) during the COVID-19 pandemic.

METHODS

Consecutive patients attending CPC between September 2020 and November 2021 were surveyed. CPC time was recorded by staff. F2F time was reported by patients and administrative data.

RESULTS

A total of 591 patients attended the CPC. A total of 176 responses were collected for F2F clinic. Regarding satisfaction, 90% of CPC patients responded "happy" or "very happy." 96% reported feeling "safe" or "very safe." Patients spent significantly less time in CPC compared to F2F (17 ± 8 vs. 50 ± 24 min, p < .001).

CONCLUSION

CPC had excellent patient satisfaction and superior time efficiency compared to F2F.

The emergency nurse responses to triage interruptions and how these responses are perceived by patients: An observational, prospective study

BACKGROUND

Healthcare providers' responses to triage interruptions in the emergency department affect quality of care. The purposes for this study were to (1) Examine the relationship between nurses' response to triage interruption and each of, patients' perceived confidence in nurses' technical skills, perceived competence of triage nurse, and satisfaction with the triage experience, (2) Examine the relationship between nurses' response to triage interruption and nurse demographics.

METHODS

Using an observational, prospective design, this study was conducted in an adult academic level 1 trauma center. Data collection tools were: The Triage Interruptions Assessment Tool, Triage and Provider Satisfaction and Confidence Survey, and Demographic Questionnaire.

RESULTS

The number of observed triage interviews is 93. Of them, 66 interviews were interrupted. No significant relationships were found between nurses' response to the interruption and patients' perceived confidence in nurses' technical skills, competence of triage nurse, or satisfaction with triage experience. There were no significant relationships between nurses' response to triage interruptions and nurses' demographics.

CONCLUSIONS

Triage interruptions in the emergency environment are common and most often result in delays in care. In the current study, this has not been shown to affect patients' satisfaction. Nurses' individual characteristics did not affect their responses to triage interruptions.

An Educational Intervention to Enhance Palliative Care Training at HBCUs

CONTEXT

Primary palliative care training is important for clinicians at Historically Black Colleges and Universities (HBCUs) given the decreased access to specialty palliative care among Black patients and patients' preferences for race concordant care.

OBJECTIVES

To describe the impact of a palliative care educational intervention at two HBCUs.

METHODS

We administered a palliative care educational intervention in family and internal medicine residency programs at Morehouse School of Medicine and Howard University College of Medicine. Pre- and post-intervention surveys were sent to residents assessing attitudes toward their palliative care education and their perceived competency in specific palliative care domains. The results were analyzed using Chi-squared analysis.

RESULTS

A total of 105 of 191 (response rate 55%) residents completed pre-intervention surveys and 101 of 240 (42%) completed post-intervention surveys. Prior to the intervention, 50% of residents rated their overall preparedness in palliative care as a 7 or above (0-10 Likert scale); 78% (P < .01) of respondents reported ≥7/10 after the educational intervention. While post-intervention residents did not feel better prepared to treat symptoms, a higher percentage reported feeling well prepared to deliver bad news (41% post-intervention vs. 23% pre-intervention) and conduct a family meeting (44% post-intervention vs. 27% pre-intervention) (P < .05). Pre-intervention, 14% of residents felt their overall palliative care education was very good or excellent, while post-intervention ratings increased to 30% (P < .01).

CONCLUSION

Residents' confidence in their preparedness to provide palliative care, particularly in their communication skills increased after an intervention at two HBCUs.

Relationship between self-care compliance, trust, and satisfaction among hypertensive patients in China

Introduction

Hypertension is a growing public health concern worldwide. It is a leading risk factor for all-cause mortality and may lead to complications such as cardiovascular disease, stroke, and kidney failure. Poor compliance of hypertensive patients is one of the major barriers to controlling high blood pressure. Compliance is not ideal among Chinese patients, and increasing patient self-care compliance with hypertension is necessary.

Methods

This article analyzes the status of self-care compliance, trust, and satisfaction among Chinese hypertensive patients using cross-sectional data from Zhejiang Province. We use a multi-group structural equation model (MGSEM) to compare the interrelationships across genders.

Results

The study's findings show that the average trust, satisfaction, and compliance scores are 3.92 ± 0.55, 3.98 ± 0.61, and 3.33 ± 0.41, respectively. Female patients exhibit higher average total scores for trust and compliance than male patients. The SEM results indicate that trust has a direct positive association with compliance [β = 0.242, 95% CI: (0.068, 0.402)] and satisfaction [β = 0.260, 95% CI: (0.145, 0.367)], while their satisfaction is not directly associated with compliance. The results of MGSEM show that trust has an indirect effect on compliance in the male group through satisfaction [β = 0.051, P < 0.05, 95% CI: (0.012, 0.116)]. In the female group, trust has a direct effect on satisfaction [β = 0.235, P < 0.05, 95% CI: (0.041, 0.406)] and compliance [β = 0.319, P < 0.01, 95% CI: (0.086, 0.574)].

Discussion

This study reveals the mechanisms of self-care compliance, trust, and satisfaction among Chinese hypertensive patients. Its findings may serve as a reference for guiding primary healthcare providers to improve hypertension patients' compliance and implement gender-targeted health interventions.

Assessment of Knowledge, Perception, Experience and Phobia toward Corticosteroids Use among the General Public in the Era of COVID-19: A Multinational Study

BACKGROUND

Corticosteroids play a significant role in managing the vast majority of inflammatory and immunologic conditions. To date, population-based studies on knowledge and attitudes concerning corticosteroids are scarce. This study aims to comprehensively assess knowledge, perception, experience and phobia toward corticosteroid use among the general population in the era of COVID-19.

METHODS

A cross-sectional self-administrated questionnaire was used to collect the data from 6 countries. Knowledge and corticophobia scores, descriptive statistics and logistic regression were computed.

RESULTS

A total of 2354 participants were enrolled in this study; the majority were females (61.6%) with an average age of 30. Around 61.9% had been infected previously with COVID-19, and about one-third of the participants had experience with corticosteroid use. The mean knowledge score was relatively satisfactory (8.7 ± 4.5 out of 14), and Corticophobia ranked a high score in all countries. Age, female gender, and history of COVID-19 were positively correlated with developing corticophobia.

CONCLUSION

Our study highlights that the general knowledge about steroids was satisfactory. However, the phobia toward its use upon indication is high. Therefore, enhancing awareness and providing essential counseling regarding the rational use of corticosteroids may reduce corticophobia.

Patients' satisfaction on primary healthcare services in China and its associated factors during COVID-19 pandemic: A cross-sectional study

INTRODUCTION

The provision of a satisfactory service by community healthcare centres in China plays an important role in the prevention and control of communicable diseases, especially during the COVID-19 pandemic. However, there is a lack of study in this field. This study aimed to determine the level of patient satisfaction with primary healthcare services in China and its associated factors during the COVID-19 pandemic.

METHOD

This cross-sectional study was conducted at 10 primary healthcare clinics in Xi'an, China. The 18-Item Patient Satisfaction Questionnaire was used for data evaluation and SPSS version 23.0 for data analysis.

RESULTS

A total of 315 patients were recruited. The overall patient satisfaction score was 26.1±3.1. In the multiple linear regression analysis, the highly educated patients had a higher patient satisfaction score than the low-educated patients (β=1.138, 95% confidence interval=0.135-2.141, P=0.026).

CONCLUSION

The overall patient satisfaction level of the patients who attended community healthcare centres in Xi'an was high. The patients with a higher educational level showed a higher patient satisfaction level than did those with a lower educational level.

Determinants of Patient Satisfaction in Indigenous Cancer Palliative Care Services

Optimal quality of care remains an integral formal service along the continuum of care pathway. Patient satisfaction is an important health system responsiveness goal which has been shown to influence quality of care except in the indigenous settings. This study identified the determinants of patient satisfaction in the context of indigenous palliative care in Kenya. A descriptive cross-sectional study was conducted among cancer patients exiting indigenous care outlets located in 12 towns across Kenya using a structured modular questionnaire. Exit interviews were undertaken with 433 respondents leaving 193 mapped indigenous outlets. Overall services satisfaction was assessed as the dependent variable using a computed single-item satisfaction mean score. The data was analyzed using IBM Statistical Package for Social Sciences version 22. 0. Bivariate and multivariate analyses were conducted to identify the potential determinants. Against the 433 study respondents, 248 (57.3%) expressed overall satisfaction with indigenous palliative care services: Satisfaction was positively associated with waiting time (AOR = 2.663, 95% CI = 1.235-5.743), provider attention (AOR = 3.698, 95% CI = 1.657-8.254), provider politeness (AOR = 6.774, 95% CI = 3.697-12.413) and provider social communication skills (AOR = 6.520, 95% CI = 3.642-11.673). Good patient-provider interaction, provider social skills and service waiting time influence patient satisfaction with indigenous palliative care. The finding contributes to the understanding of indigenous palliative cancer care and provides scientific evidence for providers and policy makers to redesign and improve their service and outlet setting to provide patient centered holistic palliative care.

Patients' satisfaction with nursing care quality and associated factors: A cross-section study

AIM

This research aimed to evaluate patients' satisfaction with the nursing care quality during their hospitalization.

DESIGN

Quantitative cross-sectional descriptive design.

METHODS

A convenience sample of 238 patients were recruited from hospitals in two provinces in Saudi Arabia. Patient satisfaction was measured by the Arabic version of the Patients' Satisfaction with Nursing Care Quality Questionnaire (PSNCQQ-Ar).

RESULTS

Significant differences were found between Saudi provinces regarding the overall quality of nursing care (M = 4.65, p < 0.001). The study revealed mean significant variations between patient satisfaction with nursing care and sociodemographic factors, including age (p = 0.002), education level (p = 0.047), marital status (p = 0.017), employment status (p = 0.038), urban vs. suburban residence (p = 0.006), length of hospitalization (p = 0.001), and accompaniment by a family member (p = 0.014). Improving patients' experience during their hospitalization requires regular examination of the quality of nursing care services.

PATIENT CONTRIBUTION

This research enhances our understanding of patients satisfaction toward the quality of nursing care received during hospitalization.

Patient satisfaction with hospital services in COVID-19 era: A cross-sectional study from outpatient department of a tertiary care hospital in Jammu, UT of J&K, India

Background

In the coronavirus disease (COVID-19) era, healthcare delivery toward patient-centered orientation has gone a paradigm shift. High levels of adherence to treatment and recommended prevention are usually the outcome of perceived patient satisfaction.

Aims

The present study aimed to assess patient satisfaction levels in the COVID-19 era and explore its determinants.

Settings and Design

A cross-sectional study from outpatient department of a tertiary care hospital in Jammu, UT of J&K, India.

Materials and Methods

The present cross-sectional study was carried out in outpatient department of a tertiary care hospital in the Jammu district. A total of 220 patients were interviewed using consecutive sampling. The tool used to assess patient satisfaction was the patient satisfaction questionnaire-18 (PSQ-18).

Statistical Analysis

Data were analyzed using Statistical Package for Social Sciences (SPSS) version 20.0. Tests of significance used were ANOVA and t-test.

Results

The overall mean satisfaction score was found to be 2.91 ± 0.17 and it was highest in the communication domain (3.12 ± 1.50), whereas it was lowest in the accessibility and convenience domain (2.73 ± 1.17). Except for religion, which was found to be statistically significant (P < 0.05) with overall mean satisfaction score, other sociodemographic variables (occupation, marital status, and monthly family income) were found to be statistically insignificant (P > 0.05).

Conclusions

Out of the seven subscales of patient satisfaction, results revealed high scores for communication and financial aspects. Only religion as a demographic variable was found to be significantly associated with patient satisfaction scores. There is a need to improvise the healthcare services in this COVID-19 era in such a manner so that we can contribute to better patient trust leading to a positive influence on health outcomes.

The Nexus Between Physician-Patient Communication and Health Outcomes: Level of Patient Communication Satisfaction and Its Impact on Adherence in Ethiopian Comprehensive Specialized Hospitals

Introduction

This study aims at assessing the level of patient communication satisfaction and its impact on patient adherence among public hospitals in Ethiopia.

Methods

The study employed a cross-sectional design. Data were obtained using Communication Assessment Tool (CAT) and the Adherence to Refills and Medication Scale (ARMS) administered to 381 patients asking them to evaluate satisfaction with physician-patient communication and report their level of adherence respectively. Both descriptive and inferential statistics were computed. Accordingly, the study used correlation, independent samples t-test, one-way ANOVA, and linear regression to show causal relationships among factors in physician-patient communication and their effect on adherence.

Results

The findings revealed that the total mean score for communication satisfaction was M = 2.69, showing that the majority of participants were dissatisfied with the physician-patient communication. Further, age and frequency of visits were significantly associated with communication satisfaction, while sex, place of residence, employment, educational level, and marital status failed to produce a systematic effect. The correlation between patient satisfaction with communication scores on the CAT questionnaire was significantly correlated with pharmaceutical adherence (ARMS score) (r = 0.316, p < 0.001), indicating that when patients were satisfied with communication, the level of adherence increased. The regression coefficient also showed that positive relationship was found between communication satisfaction and adherence (b = 1.85, t = 9.759, p < 0.05), indicating that with better quality of communication, the level of adherence also increased.

Conclusion

The majority of participants were found to be dissatisfied with the physician-patient communication. The more satisfied the patient is with communication the better their adherence.

Outpatients' satisfaction with healthcare services received at a district hospital in Botswana

Objectives

To investigate patient satisfaction regarding healthcare services at a district hospital. The research question was: what is the level of patient satisfaction regarding service delivery?

Design

An observational cross-sectional descriptive study conducted in September 2019.

Settings

A district hospital in Botswana serving a population of 90 000. Outpatients from the Eye clinic, Casualty and Outpatient Department, Sexual Reproductive Health clinic and Infectious Diseases Control Centre were selected for the study.

Participants

240 stable outpatients over 17 years selected through consecutive sampling participated voluntarily after giving informed consent.

Main outcome measures

The level of satisfaction was measured using 19 questions on five-point Likert scales ranging from strongly disagree 1, disagree 2, unsure 3, agree 4 to strongly agree 5. A binary outcome was created into satisfied and unsatisfied using the mean score as the cut-off point. Age, gender, employment, education and departments were independent variables.

Results

65% (95% CI: 58-71%) were satisfied but unsatisfied with: doctor's politeness (66.9%; 95% CI: 60-73%), explaining (67.8%; 95% CI: 61-73%), privacy (65.6%; 95% CI: 59-72%), skills (67.4%; 95% CI: 61-73%), confidence (67.4% 95% CI: 61-73%), compassion (66.5%; 95% CI: 60-72%) and waiting time (49.2%; 95% CI: 42-57%). Department visited predicted satisfaction (p=0.002); those from the Eye clinic and Sexual Reproductive Health clinic were satisfied compared to others.

Conclusion

Satisfaction was generally high but lower regarding specified services and departments visited. There is a need for targeted interventions. Studies are needed to explore reasons for lower satisfaction in Casualty, Outpatient Department and Infectious Diseases Control Centre.

Funding

None declared.

Patient-Reported Experiences and Satisfaction with Rural Outreach Clinics in New South Wales, Australia: A Cross-Sectional Study

Introduction: Many studies have been conducted on how physicians view outreach health services, yet few have explored how rural patients view these services. This study aimed to examine the patient experience and satisfaction with outreach health services in rural NSW, Australia and the factors associated with satisfaction. Methods: A cross-sectional study was conducted among patients who visited outreach health services between December 2020 and February 2021 across rural and remote New South Wales, Australia. Data on patient satisfaction were collected using a validated questionnaire. Both bivariate (chi-squared test) and multivariate analyses (logistic regression) were performed to identify the factors associated with the outcome variable (patient satisfaction). Results: A total of 207 participants were included in the study. The mean age of respondents was 58.6 years, and 50.2% were men. Ninety-three percent of all participants were satisfied with the outreach health services. Respectful behaviours of the outreach healthcare practitioners were significantly associated with the higher patient satisfaction attending outreach clinics. Conclusions: The current study demonstrated a high level of patient satisfaction regarding outreach health services in rural and remote NSW, Australia. Further, our study findings showed the importance of collecting data about patient satisfaction to strengthen outreach service quality.

Patient preferences and choices as a reflection of trust-A cluster analysis comparing postsurgical perceptions in a private and a public hospital

Background

Active participation of patients in managing their medical treatment is a major component of the patient empowerment process and may contribute to better clinical outcomes. Patient perceptions and preferences affect the patient–physician encounter in a variety of dimensions, such as patient autonomy, freedom of choice and trust in the healthcare system. The Israeli healthcare system is mostly publicly funded, with additional private healthcare services for surgery and other medical treatments. The aim of this study was to compare the perceptions and preferences of patients in the public and private hospitals in Israel.

Methods

A cross‐sectional study among 545 individuals who had surgical procedures at two hospitals in Israel (one public and one private). A structured questionnaire comprising 23 items was used to collect perceptions via personal telephone interviews. The responses were categorized into five clusters and compared by type of health services provider (public vs. private) and sociodemographic characteristics (gender, age and education level).

Results

A hierarchical cluster analysis methodology identified five conceptual groups: trust, concern towards medical errors, dialogue between medical staff and the patient/patient's family, confidentiality and staff bias towards more informed patients, or those with supportive families. Four main themes that highlight patients' preferences were found: physical conditions, personal empowerment and perceived autonomy, patient experience and patient–provider encounter communication. Significant differences between the private and the public healthcare systems were found in four clusters: trust and patient care, patient's concerns, the extent of explanation and medical staff's commitment. Differences secondary to sociodemographic parameters were noticed: patients treated at the private hospital scored significantly higher items of trust, medical staff caring and the importance of choosing their treating surgeon, while patients treated at the public hospital scored higher staff commitment to the patient than those treated at the private hospital.

Conclusions

The study revealed the perceptions underlying the decisions of patients to undergo surgical procedures in public or private hospitals. Mutual learning could pave the way to better patient–physician encounters.

Patient or Public Contribution

Patients from the two hospitals were involved in this study by responding to the questionnaire. The data presented is based on the patient's responses.

Reporting Inpatients' Experiences and Satisfaction in a National Psychiatric Facility: A Study Based on the Random Forest Algorithm

Understanding psychiatric inpatients' experiences is important to establish a culture of patient-centric care and promote trust in healthcare. This study aimed to evaluate nine dimensions of patients' experiences and investigate their association with patient satisfaction, revisit intention, and positive word-of-mouth (WoM) recommendation. Cross-sectional questionnaire data from five years of surveying (2016-2020) in the main psychiatric hospital in Bahrain were statistically analyzed, involving 763 psychiatric inpatients with an overall 65.6 ± 17.2 length of stay (days). The findings show that across the five years 2016-2020, the overall reported satisfaction was "very high" (4.75 ± 0.44) with no significant differences between these five years (F [4, 758] = 0.66, p = 0.620). The experience of confidentiality received the highest rating (4.72 ± 0.45). The experiences of ease of access, hospitality quality, and quality of responsiveness to one's needs significantly correlated with revisit intention (p ˂ 0.05). Patients with high satisfaction had greater potential for revisit intention (r [761] = 0.08, p = 0.027), which was associated with WoM recommendation (r [761] = 0.08, p = 0.033). Overall, men were less likely than women to experience convenient access to psychiatric wards. The findings of the Random Forest algorithm indicate the tendency of female patients with short-term stays to demonstrate lower satisfaction rates, and thus innovative approaches are needed when managing these groups' psychiatric problems.

From a View of the Hospital as a System to a View of the Suffering Patient

Purpose: Hospitals aspire to provide patient-centered care but are far from achieving it. This qualitative mixed methods study explored the capacity of hospital directors to shift from a hospital systemic-view to a suffering patient-view applying the Salutogenic theory.

Methods: Following IRB, we conducted in-depth narrative interviews with six directors of the six Israeli academic tertiary public hospitals, focusing on their managerial role. In a second meeting we conducted vignette interviews in which we presented each director with a narrative of a suffering young patient who died at 33 due to medical misconduct, allowing self-introspection. Provisional coding was performed for data analysis to identify categories and themes by the three dimensions of the sense-of-coherence, an anchor of Salutogenics: comprehensibility, manageability, and meaningfulness.

Results: While at the system level, directors reported high comprehensibility and manageability in coping with complexity, at the patient level, when confronted with the vignette, directors acknowledged their poor comprehensibility of patients' needs and patient's experience during hospitalizations. They acknowledged their poor capacity to provide patient-centered care. Meaningfulness in the narrative interview focused on the system while meaningfulness in the vignette interview focused on providing patient care.

Conclusions: The evident gaps between the system level and the patient level create lack of coherence, hindering the ability to cope with complexity, and are barriers to providing patient-centered care. To improve the delivery of patient-centered care, we suggest ways to consolidate the views, enabling the shift from a systemic-view to a patient-view.

Patient satisfaction level and its determinants after admission in public and private tertiary care hospitals in Bangladesh

Introduction

Patient satisfaction is an important indicator of the quality of care provided by health care facilities. The objective of this study was to investigate the rate of satisfaction and its associated factors among the patients admitted to tertiary care hospitals in Bangladesh.

Methods

This cross-sectional study was conducted in a public and two private tertiary care hospitals in Bangladesh in December 2019, including 923 consecutive patients admitted to medical and surgical departments. Face-to-face interview using a structured questionnaire was conducted to collect patient-level data. Logistic regression models were used to determine the factors associated with patients' satisfaction.

Results

Patients' overall satisfaction level was 65% (51% in public and 75% in private hospitals) with a satisfaction rate of 63% in hospital staff courtesy, 56.5% in a hospital environment, 67% in physician care, 63% in general patient satisfaction, and 58% in patient's family care. Private hospitals (aOR 3.64, 95% CI 2.2-6.03), conservative management (aOR 3.34, 95% CI 2.10-5.33), shorter hospital stay (aOR 1.58, 95% CI 1.05-2.37) and perceived improvement after treatment (aOR 1.67, 95% CI 1.01-2.76) were associated with patients' satisfaction. In contrast, patients' accommodation on the floor (aOR 0.38, aOR 0.22-0.66) and high health care costs (aOR 0.97, 95% CI 0.95-0.99) were associated with patients' dissatisfaction with the in-patient service they received in both public and private hospitals.

Conclusion

Almost two-thirds of the patients were satisfied with the inpatient service they received, though, the satisfaction rate was higher in private hospitals. Treatment modality, cost, and outcome, as well as hospital environment like accommodation, were associated with their satisfaction level.

Assessment of Emergency Department Satisfaction Level in Saudi Arabia General Hospital

Background and objectives:

An overcrowded emergency department (ED) cannot meet the patients’ growing demand. This situation harms employees’ performance and, alternatively, causes anxiety and dissatisfaction among patients since the quality of healthcare outcomes fall below their expectations. This study aimed at improving and validating a scale for assessing patient satisfaction in the ED.

Methods:

In this study, 134 participants from Wadi Al-Dawasir General Hospital were enrolled using a convenient sampling technique. A cross-sectional survey was conducted using 5-point Likert scales.

Results:

All tested hypotheses showed statistical significance (P < 0.05). Our results show that male employees were more satisfied compared with their female counterparts. Furthermore, Saudi employees were more satisfied with the health services than non-Saudi ones.

Conclusion:

The findings of this study brought to the fore that patients and their families were satisfied with the healthcare services and their quality. This means better service delivery played a crucial role in enhancing satisfaction levels. Nevertheless, this study also highlights that overcrowding is a significant problem for healthcare organizations. Wadi al-Dawasir General Hospital's ED should continually improve its quality to meet the growing needs of its clients.

Providers' perspectives on the performance of primary healthcare centres in India: The missing link

BACKGROUND

Primary healthcare centres (PHCs) form the foundation of the Indian public health system, and thus their effective functioning is paramount in ensuring the population's health. The World Health Organisation (WHO) has set six aspects of performance assessment for general health systems, which are hardly applicable to the PHC setup in a low- and middle-income country. The Primary Health Care Performance Initiative (PHCPI) has prescribed a framework with five domains consisting of 36 indicators for primary healthcare performance assessment from a policy point of view. For the assessment to be realistic, it should include inputs from stakeholders involved in care delivery, so this study examines the perspectives of healthcare providers at PHCs in India.

METHODOLOGY

The authors used qualitative research methodology in the form of responsive evaluations of healthcare provider's interviews to understand the indicators of PHC performance.

RESULTS AND CONCLUSION

The study results showed that healthcare providers considered efficient teamwork, opportunities for enhancing provider skills and knowledge, job satisfaction, effective PHC administration, and good community relationship as PHC performance assessment. These domains of performance could be considered the 'missing link' in PHC assessment, since they are deemed important by providers and did not coincide with the WHO aspects and the PHCPI performance assessment framework.

"Passing Out is a Serious Thing": Patient Expectations for Syncope Evaluation and Management

PURPOSE

Syncope is a complex symptom requiring thoughtful evaluation. The ACC/AHA/HRS published syncope management guidelines in 2017. Effective guideline implementation hinges on overcoming multilevel barriers, including providers' perceptions that patients prefer aggressive diagnostic testing when presenting to the emergency department (ED) with syncope, which conflicts with the 2017 Guideline on Syncope. To better understand this perceived barrier, we explored patient and family caregiver expectations and preferences when presenting to the ED with syncope.

PATIENTS AND METHODS

We conducted semi-structured focus groups (N=12) and in-depth interviews (N=19) with patients presenting to the ED with syncope as well as with their family caregivers. Interviews were recorded, transcribed verbatim, and analyzed by a team of researchers following a directed content analysis. Results were reviewed and shared iteratively with all team members to confirm mutual understanding and agreement.

RESULTS

Syncope patients and caregivers discussed three main desires when presenting to the ED with syncope: 1) clarity regarding their diagnosis,; 2) context surrounding their care plan and diagnostic approach; and 3) to feel seen, heard and cared about by their health care team.

CONCLUSION

Clinicians have cited patient preferences for aggressive diagnostic testing as a barrier to adhering to the 2017 Guideline on Syncope, which recommends against routine administration of imaging testing (eg, echocardiograms). Our results suggest that while participants preferred diagnostic testing as a means to achieve clarity and even a feeling of being cared for, other strategies, such as a patient-engaged approach to communication and shared decision-making, may address the spectrum of patient expectations when presenting to the ED with syncope while adhering to guideline recommendations.

Satisfaction and associated factors towards inpatient health care services among adult patients at Pawie General Hospital, West Ethiopia

INTRODUCTION

Improving the quality of services is the primary goal of the Ethiopia reform program to satisfy patients. Patient satisfaction is an attitude resulting from a person's general orientation towards a total experience of health care. According to world health organization consumer satisfaction is playing an increasingly important role in the quality of care reforms and health-care delivery more generally.

OBJECTIVE

To assess patient's satisfaction and associated factors with health care services among admitted patients in Pawie General Hospital, Benishangul Gumuze Region, West Ethiopia, 2020.

METHODS

Institution based cross-sectional study was conducted among adult patients admitted to Pawie General Hospital. A systematic random sampling technique was employed to recruit 334 participants and a structured interviewer-administered questionnaire was used to collect data. Data were entered into Epi Data version 3.1, analyzed using SPSS version 23, and presented in tables and graphs. Bivariable and multivariable logistic regressions were computed to identify factors associated with patient satisfaction. P-values < 0.05 and adjusted odds ratios were used to declare the significance and strength of the association.

RESULT

The overall patient's satisfaction towards inpatient health care services at Pawie General Hospital was 60.8% with 95% CI (55.4, 65.9). Factors like admission ward [AOR = 2.60; 95% CI (1.34, 5.03)] and privacy [AOR = 12.5; 95% C I (2.89, 54.1)] were significantly associated with patient's satisfaction.

CONCLUSION

The satisfaction level of patients admitted to Pawie General Hospitals was low. Admission ward and perceived privacy assured were factors significantly associated with patient satisfaction among patients admitted to Pawie General Hospital. The hospital administration system is better to work together to fill the gaps identified and improve the level of patient satisfaction.

Assessment patient satisfaction towards emergency medical care and its determinants at Ayder comprehensive specialized hospital, Mekelle, Northern Ethiopia

BACKGROUND

As the healthcare industry shifts toward patient-centered models, providers will need to fully understand patient satisfaction and how they affect their practices. This study aimed to assess patient satisfaction towards the emergency medical care and factors associated with at Ayder specialized comprehensive hospital, Emergency room, Mekelle, Ethiopia.

METHODS

An institution-based cross-sectional study was conducted from March 1-30, 2019. A systematic random sampling method was used to enroll 299 study participants. Data were collected using a standard Brief Emergency Department Patient Satisfaction Scale questionnaire by trained data collectors. Data was entered into EpiData 3.1 then exported and analyzed by SPSS version 22. Binary and multiple logistic regression were used to assess the factors associated with patient satisfaction. Where the p-value of <0.05 was considered significant.

RESULTS

A total of 299 participants were enrolled in the study with a response rate of 99.3%. On overall patient satisfaction score majority (81.9%) of them were satisfied with the emergency medical care provided. The satisfaction rate towards emergency staff courtesy, emergency room environment, physician care satisfaction, general patient satisfaction, and patient family satisfaction was 80.3%, 37.5%, 75.9%, 70.9%, and 49.8% respectively. Those who arrived during the morning time of the day tend to be satisfied more with the emergency services (AOR = 4.8, 95% CI: 2.08, 11.4), while having low educational status (able to read and write) (AOR = 0.12, 95% CI: 0.03, 0.50) and waiting time till seen by a doctor (AOR = 1.3, 95% CI: 1.003, 1.4) was found to affect patient satisfaction negatively.

CONCLUSIONS

The total patient satisfaction score towards emergency medical care was found to be good. The hospital management and emergency room staff should act on the identified factors especially on minimizing the patients waiting time to improve the quality of care in the emergency department.

Inter-personal versus content: assessment of communication skills in Iraqi physicians

OBJECTIVES

The current study sought to evaluate the communication skills of Iraqi physicians from a patient perspective, differentiating between "interpersonal" and "content" components of communication. In the past century, the doctor-patient relationship has changed considerably, shifting from a paternalistic, physician-dominated approach to a more dynamic and patient-centered. In such a context, effective communication skills have become even more crucial for good medical practice and most accreditation organizations urge medical schools to teach and evaluate communication skills.

METHODS

A cross-sectional study was conducted at Baghdad Teaching Hospital's three major departments (Surgery, Medicine, Obs/ Gyne). The final sample included 270 participants. A factor analysis was performed and generated two dimensions ("interpersonal" and "content"). Statistical differences between the groups and between the two dimensions of the questionnaire were analysed through t-tests and ANOVA. In addition, a multiple linear regression model was used to study the effect of some variables on the dependent variable "communication".

RESULTS

The study showed a significant difference between "interpersonal" and "content" communication, with patients reporting higher satisfaction for the former. Reported satisfaction rates varied amongst the three departments with the Surgery specialty scoring significantly lower than the Medicine and the Obs/Gyne department. The duration of care under the current physician, a higher rank of specialty and the settings (inpatients versus outpatients) were positively and significantly associated with a higher quality of communication skills.

CONCLUSIONS

These findings have significant implications for training institutions.