The meaning of patient satisfaction: an explanation of high reported levels

The social policy background to the proliferation of patient satisfaction surveys is a desire for increased patient representation and participation. Within this context, it is assumed that satisfaction surveys embody patients' evaluations of services. However, as most surveys report high satisfaction levels, the interpretation of satisfaction as the outcome of an active evaluation has been called into question. The aim of this study is to identify whether and how service users evaluate services. This was made possible through unstructured in-depth interviews with users of mental health services and through more structured discussion around their responses on a patient satisfaction questionnaire (CSQ 18B) whose psychometric properties has been well documented. Twenty-nine people with current or recent contact with mental health services within the British National Health Service were interviewed. The data revealed that service users frequently described their experiences in positive or negative terms. However, the process by which these experiences were transformed into "evaluations" of the service was complex. Consequently, many expressions of "satisfaction" on the CSQ 18B hid a variety of reported negative experiences. An explanation for this lack of correspondence is outlined.     

Glucagonomas/diabetico-dermatogenic syndrome (DDS): a statistical evaluation of 407 reported cases

The development of an appraisal questionnaire which measures junior doctors' opinions about their hospital experiences is described. The first section of the questionnaire consists of seven reliable subscales which measure opinions about teaching and learning, registrar teaching, consultant teaching, staff support, workload, administration and overall experiences during a period of attachment or term. The second part of the survey contains 11 reliable questions about the hours spent on service and education during the term. The responses to this measure of 257 randomly selected Australian junior doctors are described. The questionnaire may be used to contrast the experiences of junior doctors in different types of terms, different hospitals or varying levels of training. The data generated from the instrument can provide useful information about hospitals, such as the work practices of junior staff and the effectiveness of educational programs.     

Employee reactions to contextual and session components of performance appraisal.

A neglected area of performance appraisal research concerns the context within which the appraisal process occurs. For a sample of exempt employees, measures were developed that assessed system components of the appraisal context. The contribution of these variables (complexity, implementation, and follow-up) to the prediction of 2 measures of employee reactions to performance appraisal (review session satisfaction and appraisal system satisfaction) was compared with the contribution of a more frequently studied set of variables—supervisory behaviors in the review session. The relationship of a salary linkage variable to the 2 outcome criteria also was assessed. The supervisory session variables were related to session satisfaction, and the system contextual variables were primarily related to system satisfaction. Salary linkage was associated with system satisfaction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Quality development at an emergency unit--an intervention study based on consumer satisfaction

A study among the users of an emergency department was carried out to assess user satisfaction, based upon a questionnaire. The study was split into two periods, before and after a change in procedure in the emergency department, namely that a nurse was to give information about waiting time, make coordinations and fix an order of priority of patients (triage) in the waiting room. Fourteen hundred and twenty-six answers were received, 794 before and 632 after the change. The users questioned after this change of procedure felt that they had been better received, that they had waited for a shorter time and described a better general experience as compared to the users questioned before the change, these differences were significant. There were no difference between the two groups concerning opinions on information about diagnosis, treatment and outcome, whether there was enough time for examination, treatment and information, whether the staff were obliging or whether their expectations had been fulfilled. It is concluded that such changes in procedure in the emergency department are to be recommended.     

Strategies for collection and processing of occupational information in making career decisions.

The dialogs of 384 users of a computerized occupational information and guidance system were monitored and utilized to examine the strategies used in the exploration of occupational information. The analysis was based on the pattern of the use of the major components of the system and on the content of the requested occupational information. An analysis of the users' dialogs with the system revealed the various patterns of exploring occupational information. These patterns were interpreted as reflecting different strategies-search within alternatives across attributes, or search within attributes across alternatives. Different possible strategies, including the sequential elimination approach for career decision making, are reviewed. The implications for career counseling and computerized career decision making systems are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A new instrument to measure patient satisfaction with mammography. Validity, reliability, and discriminatory power

OBJECTIVES: The benefit of mammography depends on repeated use. Therefore, surveying the mammographic quality as judged by the users addresses an important topic. The authors assess the practicality, validity, reliability, and discriminatory power of a new, brief, multidimensional questionnaire for measuring patient satisfaction with mammography. Items measuring discomfort and attitudes toward repeat adherence were included. METHODS: A self-administered questionnaire was given to women from six radiology departments in Norway. Four hundred eighty-eight out of 550 women referred for screening or diagnostic mammography were included. Seventy-seven patients also completed the test/retest study, and 44 women additionally completed an Australian questionnaire. Scores for patient satisfaction on the structure, process, discomfort, and general satisfaction scales of the questionnaire were used as the main outcome measures. RESULTS: Response rate was 89%, and rate of completion was more than 95%. Strict psychometric criteria for construct validity and reliability were satisfied. Because lower levels of satisfaction were detectable with the new questionnaire but not with the Australian questionnaire and because an acceptable degree of variability in response was detected, support for discriminatory power was found. CONCLUSIONS: The discomfort dimension contributed substantially to validity and discriminatory power. Patient behavior with time may be monitored with the new questionnaire, thus representing a valuable tool for scientific and practical purposes.     

A patient's perspective on the management of peptic esophageal stricture: experience and results in 113 consecutive cases

A retrospective analysis of 113 consecutive cases of benign esophageal stricture, all secondary to gastroesophageal reflux, 100 treated conservatively, 13 treated surgically, has been carried out in conjunction with a postal questionnaire of patients. Patients were requested to grade both their swallowing ability and the acceptability of their treatment. Of those responding to questionnaire, 88% of patients treated conservatively found their treatment acceptable or better, and 72% were left with either no or minimal restriction of diet. There was no correlation between either the total number or frequency of dilatations and the result achieved. Similarly, patient satisfaction appears largely independent of these variables. Doctors should be wary of taking recurrence of a stricture after initial dilatation as indicating a poor eventual outcome or a dissatisfied patient. There was no difference in terms of either the result or patient satisfaction between conservatively treated and surgically treated patients.     

An aid in interpersonal relations and nursing]

This paper discusses user support in the context of a library-managed online database search service. Experience is drawn from the British Medical Association (BMA) Library's Free MEDLINE Service. More than 9,600 BMA members, who are largely unfamiliar with computer communications and database searching, have registered as users of the service. User support has played a significant role in the development of the service and has comprised four main aspects: an information pack, a help desk, online help, and MEDLINE courses. The paper includes an analysis of help desk usage statistics collected from January 1996 through June 1996, and highlights other relevant research. Plans for further service enhancements and their implications in terms of future user support are discussed.     

An analysis of managers' reactions to their own performance appraisal feedback.

Individuals' reactions to their performance appraisal interviews were examined in two analyses of managers who appraised their subordinates. We hypothesized that managers' reactions toward their own appraisal interview would be influenced by both supervisor satisfaction and favorability of the feedback they received. We also hypothesized that managers' reactions would be affected by system satisfaction (i.e., their attitudes toward the system's ability to document the performance of their subordinates). Questionnaires were administered to managers in eight colleges and universities in one state system. Results indicated that managers distinguished between satisfaction with their own appraisal and its value in improving performance. Appraisal satisfaction was predicted by supervisor satisfaction and the recollection of their rating, but not system satisfaction. In a follow-up analysis, results were confirmed with managers in the original sample. The appraisal's improvement value was associated with supervisor satisfaction, and inversely related with performance rating. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Impact of the presequence of a mitochondrium-targeted precursor, preadrenodoxin, on folding, catalytic activity, and stability of the protein in vitro

Pharmaceutical companies are responsible for providing updated, relevant information on the efficacy, safety and quality of drugs to medical professionals and finally to patients. To fulfill this responsibility, we must always endeavour to collect and evaluate the relevant information. We developed a drug information database system called Advanced Medical Online Network of Daiichi (AMOND) to manage various information generated during development of new products and after launch of the products using the classification format for retrieval. This system has been used for 9 years for the purpose of supporting medical representatives who play a primary role in the drug information services in the pharmaceutical industry. This system is incorporated into an on-line network system, and can be directly accessed by more than 1200 people at 11 branch offices and more than 110 subbranches all over the country. We upgraded this system to AMOND-II to improve the function, including retrieval and output abilities. As a result, utilization by users of this system increased six times. We report on the improved system, AMOND-II and our experience of the system.     

Measuring treatment outcome and client satisfaction among children and families: A case report.

Formal assessment of client satisfaction and treatment outcome is more frequently being requested as a component of mental health services. This article outlines a treatment outcome and client satisfaction program implemented at the Children's Health Council, a private nonprofit mental health agency in Palo Alto, California, affiliated with the Stanford University Medical Center. The program was designed to be simple and inexpensive, and it is intended to serve as an example for other agencies and practicing professionals wishing to measure treatment outcome and client satisfaction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Role satisfaction of psychologists in state hospitals.

"All midwestern, state employed, institutional psychologists listed in the 1960 APA Directory (N = 131) were requested to return an anonymous questionnaire. Seventy-one persons responded from the nine states included." As years of state employment increase the actual satisfaction and abstract expectation levels both rise. Master's level psychologists "tend to respond with a somewhat greater job satisfaction than do PhD staff members… . Psychologists who reported working in institutions with a frankly organic orientation express a lesser percentage of satisfaction on the PA [Professional Activities] scale than do psychologists reporting a psychologic orientation." State employed clinical psychologists "as a group are reasonably well satisfied spending almost 80% of their time in gratifying activities." From Psyc Abstracts 36:01:3AL23M. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Incorporating Domain Knowledge and Information Retrieval Techniques to Develop an Architectural/Engineering/Construction Online Product Search Engine

This paper introduces a domain-specific search engine, which was developed to take advantage of the growing online product information for surveying the virtual product market. Knowledge about a product was uniquely incorporated with query expansion operations and the extended Boolean model retrieval approach to handle issues associated with the search engine development. The search engine was designed to (1) represent and utilize the represented knowledge in the product domain; (2) identify online product information; and (3) then evaluate the collected online product information. A prototype search engine for testing was developed and statistically validated with five data sets with each data set being derived from a different type of product according to MasterFormat (Alexandria, Va.) categorization. The validation results indicated that compared with the tested general search engine or aggregated information service, the prototype was able to identify more distinct product manufacturers for procurement-related decision support.     

Using the World-Wide Web to train and certify physicians in the safe use of fluoroscopy

OBJECTIVE: We sought to create a computer-generated certification examination that concurrently tests and educates fluoroscopy users. MATERIALS AND METHODS: A trial examination was placed on the Internet for area physicians who requested fluoroscopic privileges at our institution. The name and address of each individual who achieves a passing score is automatically sent by e-mail to the examination administrator. RESULTS: Physicians expressed widespread satisfaction with this certification process. The difference in number of attempts and score of the first attempt between groups of radiologists and nonradiologists favored the radiologists (p approximately .03 in both cases) when analyzed using an unpaired t test. CONCLUSION: This examination ensures understanding of the procedural parameters that contribute to skin injury in patients and affords an easy approach to self-education.     

Resistance to interference in human associative learning: evidence of configural processing

This article provides a conceptual and practical framework called the Ecology of Outcomes. Based on this framework, agencies that serve children and families build and use outcome-oriented information systems to respond to their clients in a more flexible manner. The goal is to improve promising programs by involving stakeholders in outcome identification and in utilization of results. Problems addressed include the emphasis human services place on rules compliance, lack of feedback to program staff to allow for midcourse correction, and lack of input by key stakeholders in the identification of outcomes to be measured. The following components of the framework are described: principles of outcome accountability, prerequisites and building blocks, implementing an outcome information system, and utilizing the results. Key elements of the framework are the integration of outcome information into a service system's decision-making process and the inclusion of client, stakeholder, and provider satisfaction information.     

A computer program for the geographic distribution of fluvial mollusks of medical interest in Cuba

The need to know the distribution of mollusks considered to play an important medical role in Cuba through a geographic representation motivated us to develop a software capable of acting as a system for the retrieval of geographic information in which the requested data would be presented in maps. The system has been called DMIM and it is a useful tool for malacological studies, and assessment and planning of programs for the control of intermediate host mollusks, as well as for teaching purposes.     

Symptom characteristics of counseling center and mental health service clients.

Selected university students who requested either personal counseling at the counseling center (43 males and 101 females) or psychotherapy at the mental health service (40 males and 53 females) were administered the Symptom Distress Checklist-90. This is a self-report symptom rating scale intended to assess the degree of distress associated with presenting symptoms; scores are organized along 9 symptom dimensions and 3 global indices of pathology. There was no significant difference between users of the counseling center and users of the mental health service when compared on levels of distress associated with presenting symptoms. The implications of these findings for the organization of mental health service delivery programs on a university campus are discussed. (9 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Subordinate participation and reactions to the appraisal interview.

Conducted 2 studies which examined relationships of subordinate participation in an appraisal interview to reactions to the appraisal and subordinate satisfaction. In Study 1, 25 managers rated their last appraisal on (a) helpfulness and (b) the Wexley et al measure of psychological participation, and then rated their overall satisfaction with supervision. The lack of significant intercorrelations among the psychological participation items indicated that different concepts of participation were represented. Items representing participation in interaction correlated significantly with appraisal helpfulness and satisfaction, while control of goal setting did not correlate significantly. In a 2nd field study, 56 hourly employees and 1st-level managers in a bank rated (a) their appraisal on certain characteristics, (b) their satisfaction with the appraisal, and (c) their job satisfaction. The invitation to participate was most predictive of appraisal satisfaction. The occurrence of goal setting correlated significantly with both appraisal and job satisfaction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Caring for a family member with a traumatic brain injury

The responses to a questionnaire on subjective burden are reported for 52 primary caregivers of a group of persons with traumatic brain injuries sustained an average of 6 years previously. The aim of the study was to examine satisfaction with social support, perception of coping skills, and appraisal of symptoms as predictors of strain in the carers. A range of responses, both positive and negative, to the work of caring for a relative with a head injury was reported. A high prevalence rate of emotional and behavioural changes in the persons with head injuries was found and the amount of distress caused by these symptoms was found to be predictive of burden. The other factor important in predicting burden was the carers' ratings of their satisfaction with their ability to cope with the work of caregiving. Social support, injury severity, and the demographic characteristics of the persons with head injury and their carers were not significant predictors. Depression in the carers was also investigated and the variable most predictive of elevated depression scores was coping satisfaction. These findings reinforce the importance of strengthening carers coping resources in rehabilitation work with head injured persons and their families.