Couples'' satisfaction with health care service during labor and delivery

In recent years, favorable results have been achieved in patients suffering from azoospermia by microinsemination of spermatozoa taken from their testes. Microinsemination is being introduced in the treatment of patients who have no spermatozoa in their testes via their spermatid and spermatocyte. There are still doubts relating to immature male germ line-cells, such as whether they have, oocyte activating factors, the level of stability of DNA of cell nuclei, and the differences in chromosome numbers. The relatively few cases of gestation using the human spermatid treatment may be due to embryological problems resulting from the instability of nuclear DNA and the insufficiency of oocyte activating factors, which are the result of imperfect microinjection techniques. Improvements in techniques for the clinical application of spermatid and secondary spermatocyte, as well as the collection of basic data to confirm embryological safety are therefore necessary.     

Work satisfaction of health personnel in primary care

OBJECTIVE: To determine the level of work satisfaction of health professionals working in Primary Care and to establish the social, demographic and professional factors which determine it. DESIGN: An observational, crossover study using a self-administered questionnaire. SETTING: Primary Care. PARTICIPANTS: All the doctors and nurses working in the Primary Care teams in the Albacete Health Area (468 in all). MEASUREMENTS AND MAIN RESULTS: The scale of work satisfaction of health professionals in Primary Care teams was used. Social, demographic and professional data were collected. 9 dimensions or components of work satisfaction were identified through a factorial analysis. The lowest scores were for motivation, opportunities for professional development and coordination with specialists. CONCLUSIONS: The findings show, in general, indifference as to work satisfaction or lack of it in areas such as motivation and opportunities for professional development. The differences observed in those polled relate to their job and work-place, and also, in the case of doctors, to specialist training.     

Gender differences in satisfaction with primary care physicians in a managed care health plan

This study examines whether the formation of satisfaction with primary care physicians in a managed health care plan differs for men and women. Findings indicate that there are significant differences in the formation of satisfaction. For both men and women, the probability that an individual is satisfied is influenced by the type of plan enrolled in, number of problems experienced and beliefs about the quality of and access to benefits. Income and additional insurance coverage affects the probability of satisfaction for women only. Simulation analysis shows how satisfaction changes as individual characteristics and experience with managed care change.     

Behavior as the central outcome in health care.

Argues that behavioral outcomes are the most important consequences in studies of health care and medicine. These outcomes include mortality, and health-related quality of life. The trend toward the "biologicalization" of behavioral and biomedical sciences is discussed, and the question is posed as to whether medical measures are more valid or meaningful than behavior outcomes. Examples are given of the variability in behavioral health outcomes within fixed levels of biological variables such as arthritis, blood pressure, and cholesterol. The behavioral approach differs from the traditional medical model by emphasizing outcome rather than disease category. A model of behavioral health outcomes is presented in which both biological and environmental events gain importance because they affect behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Health status and satisfaction with health care: Results from the medical outcomes study.

Relations between self-assessed health status and satisfaction with health care were examined using 2 waves of data obtained from participants in the Medical Outcomes Study. Using a multisample covariance modeling framework, separate models were examined for patients with significant symptoms of depression (n?=?417 ) and patients with chronic physical health conditions (n?=?535 ). The pattern of findings was essentially identical for both patient subgroups. General satisfaction with care was cross-sectionally associated with mental?but not physical--health status. In addition, significant cross-lagged effects were found linking baseline satisfaction with care to subsequent mental health and baseline mental health to subsequent satisfaction with care. By contrast, no crosslagged directional effects linking satisfaction with care and physical health status were identified. Finally, no evidence was found that satisfaction with specific aspects of health care contributed independently to either mental or physical health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Health care characteristics associated with women's satisfaction with prenatal care

OBJECTIVES: The objective of this study was to explore the relation between prenatal care characteristics and satisfaction among Medicaid recipients. METHODS: African-American (n = 75) and Mexican-American (n = 26) nonadolescent primiparous pregnant women who had at least three prenatal care visits participated in a 25-minute telephone survey that asked them about satisfaction with prenatal care (art of care, technical quality, physical environment, access, availability and efficacy); prenatal care characteristics (practitioner attributes, service availability, and features of the delivery of care); and, personal characteristics (sociodemographics, health status and behaviors, and pregnancy-related variables). Univariate and multivariable analyses were conducted to explore the relations between personal characteristics and satisfaction and between care characteristics and satisfaction. RESULTS: For the overall sample, the following prenatal care characteristics were associated with increased satisfaction: having procedures explained by the provider, short waiting times at the prenatal care site, the availability of ancillary services, and reporting that the prenatal care practitioner was male. When examining the data by ethnicity, whether the provider explained procedures was the most important determinant of satisfaction for both African-American and Mexican-American women. CONCLUSIONS: Knowledge of the care characteristics that impact low-income pregnant women's satisfaction can be utilized to alter service delivery to increase use of prenatal care and ultimately to improve perinatal outcomes.     

Factors determining satisfaction with dental care

The objective of the present study was to study satisfaction with previous dental care in a Swedish population aged 45-69 years. The relationship between a number of factors and satisfaction with care was studied, and differences between people attending private and public dental clinics were examined. The data were collected by an anonymous questionnaire. A multivariate analysis showed that reported satisfaction with previous dental care depended primarily on three factors; treatment by the dentist of choice, chewing ability and contentment with their own dental conditions.     

Patient satisfaction with time spent with their physician

AIMS: The aim of the study was to compare the effects of meloxicam and piroxicam on the gastroduodenal mucosa in healthy adults. METHODS: Forty-four healthy volunteers were given a 28 day course of either meloxicam 15 mg, piroxicam 20 mg or placebo. Damage to the oesophageal, gastric and duodenal mucosa was assessed, mucosal blood flow (MBF) measured at endoscopy and biopsies taken for prostaglandin content and microscopic assessment of damage before NSAID administration and during days 1, 7 and 28 of continued intake. RESULTS: Maximal macroscopic gastric mucosal damage (median grade+IQR) occurred within 24 h of piroxicam administration, the damage score increasing from 0 to 2.5 (0-3) (P=0.02) at day 1 before falling to 2.0 (0-2) at day 7 and 0 (0-1) at day 28 with resolution of damage observed in six out of the seven subjects who sustained acute injury. No significant macroscopic gastric damage occurred in either of the two other groups although some minor damage was observed in seven subjects taking placebo and five taking meloxicam. There was a trend towards piroxicam causing more acute gastric damage than meloxicam (P=0.06). Baseline antral, body and duodenal MBF were similar in all three groups. No significant changes occurred in any of the groups on any of the visits. There were also no changes in gastric mucosal prostaglandin content in any group. CONCLUSIONS: These observations suggest that meloxicam causes little acute damage to the upper gastrointestinal tract and piroxicam causes some acute gastric injury but such damage resolves in most subjects by 28 days.     

Consumer satisfaction with mental health treatment.

Reviews literature on the evaluation of consumer satisfaction with mental health treatment. The methods of assessing consumer satisfaction, methodological issues in studies assessing satisfaction, results of the studies, and the value of consumer evaluation are discussed. Consumer evaluation is found to be a useful though flawed method of assessing services. It is concluded that consumer evaluation should be included in a multimethod treatment evaluation. (3 p ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Causality assessment of the acute health complaints reported in association with oxygenated fuels

Plasma levels of the hypothalamo-pituitary-adrenal axis hormones beta-endorphin (BE), adrenocorticotropin hormone (ACTH), and cortisol were measured in autistic (N = 48), mentally retarded/cognitively impaired (MR/CI, N = 16), and normal control (N = 26) individuals. Comparison of log transformed data from the three groups revealed that levels of BE and ACTH were significantly higher (p < .05) in the autistic individuals than in normal controls. The higher means in the autistic group were due to significantly higher plasma levels of BE and ACTH, indices of acute stress response, in the more severely affected individuals. The data support the idea that individuals with severe autism have a heightened response to acute stressors rather than chronic hyperarousal or elevated basal stress response system functioning.     

Comparison of patient satisfaction with ambulatory visits in competing health care delivery settings in Geneva, Switzerland

OBJECTIVES: To measure satisfaction with medical visits in various health care settings and to assess the extent to which differences in satisfaction scores between health care settings can be attributed to patients' characteristics. DESIGN: This was a cross sectional survey to measure seven dimensions of patient satisfaction. SETTINGS: Ambulatory visits to 'gatekeepers' or specialists in a newly established managed care organisation, a private group practice, or a university hospital outpatient clinic in Geneva, Switzerland. PATIENTS: There were altogether 1027 adult patients (81% participation rate). RESULTS: Patients who consulted physicians in the private group practice reported higher levels of satisfaction (overall mean 83.2 on a scale between 0 and 100) than university clinic patients (79.7), patients of independent specialists within the managed plan (78.5), and patients of managed plan gatekeepers (69.8, intergroup differences p < 0.001). Differences between settings were reduced after adjustment for sex, age, country of origin, general practitioner versus specialist visit, and scheduled versus urgent visit (adjusted scores: 80.8, 78.8, 77.6, and 72.7 in the four settings, p < 0.001). Intergroup differences were largest for general satisfaction, but small and non-significant for satisfaction with explanations given by the physician and for time spent with the patient. CONCLUSIONS: Patient satisfaction varied widely between health care settings. Differences in satisfaction ratings could be ascribed only partly to disparities in patient populations. Patients of managed plan gatekeepers were least satisfied, presumably because they could not choose their physician freely. Comparison of patient satisfaction across health care settings can provide a basis for targeted quality improvement initiatives.     

Influence of dispositional coping strategies on physical complaints and life satisfaction in the elderly

Well-being and mental and physical health in old age are influenced in a significant way by the fact that it is possible to cope successfully with ongoing hazards, threats and problems. In recent years coping research has shown increasing interest in coping processes in the elderly. Most of the studies are focused on age-related differences in coping processes and on the issue of change or stability of coping in old age. However, the goal of our study was to examine the impact of dispositional coping strategies, conceptualized as consistent personality characteristics, on physical complaints and life satisfaction among the elderly. We recurred on the model of coping modes by Krohne, which postulates two statistically independent person-specific coping dimensions named "vigilance" and "cognitive avoidance". Based on this model it is possible to identify the "classical" coping styles of "sensitization" (high vigilance and low cognitive avoidance) and "repression" (low vigilance and high cognitive avoidance). In our study, including 766 subjects older than 60 years, we found a higher frequency of "repressors" than of "sensitizers". Results show that dispositional coping strategies are significant moderator variables of both physical complaints and life satisfaction: Older people who prefer a cognitive-avoidant coping strategy ("repressors") are more satisfied with their life and have less complaints than "sensitizers".     

Reliability and validity of a self-administered questionnaire of patient health care behavior and satisfaction

The genes encoding the envelope glycoprotein H (gH) and gB homologues were identified by sequencing genomic clones of human herpesvirus-7 (HHV-7), strain JI. A gB cDNA clone from HHV-7 strain AL was also identified. The deduced primary translation products of the gH and gB genes are a protein of 690 amino acids, with a predicted mass of 80.4 kD, and a protein of 822 amino acids, with a predicted mass of 93.3 kD, respectively. Both the predicted proteins have the characteristics of transmembrane glycoproteins, containing signal and transmembrane sequence motifs and characterized by the presence of 10 (gH) and 11 (gB) potential motifs for N-glycosylation. Comparison of amino acid sequence of HHV-7 gH and gB with the homologous sequences of the other human herpesviruses reveals closest homology with HHV-6 (38.8% identity for gH, 56.2% identity for the gB). In addition, significant sequence similarity was also observed between the gH and gB of HHV-7 and the homologs encoded by human cytomegalovirus (21.6% identity for gH, 37.6% identity for gB). No significant differences existed between the gB sequence of the two different HHV-7 strains analyzed. The products of the HHV-7 gH and gB expressed transiently in eukaryotic cells were specifically recognized by an HHV-7-reactive human serum in immunofluorescence assays.     

Patients' opinions of their health status and the results of medical care

Anonymous questionnaires were distributed among patients of treatment and prophylaxis inpatient and outpatient institutions in the city of Irkutsk. Analysis of responses helped detect the causes responsible for the unfavorable initial health status of patients and decreasing the probability of favorable outcomes after treatment.     

Rhinoplasty patients' critical self-evaluations of their noses

Many applicants for cosmetic rhinoplasty do not appear to have grossly deformed noses. This study was undertaken to determine the accuracy of nasal evaluations in a group of 20 female cosmetic rhinoplasty patients, before and after surgery, relative to a matched nonrhinoplasty control group composed of 25 subjects. Self-assessments and surgeon assessments were obtained for both groups. Compared with those of controls, the noses of patients were found to be more deformed before and better shaped after the operation, according to both self-assessments and surgeon assessments. Rhinoplasty patients, in contrast to controls, tended to downgrade the shape of their noses compared with surgeon assessments both before and 4 months after surgery. Faulty evaluation was not associated with sociodemographic parameters, brief symptoms index (BSI) scores, or the degree of patient satisfaction from surgical outcome. Replication and longer-term follow-up studies are needed and are anticipated.     

Health care utilization as a function of subjective health status, job satisfaction and gender among health care workers in Guangzhou, southern China

Job satisfaction, subjective health and health care utilization was studied on 72 doctors and 127 nurses working at two hospitals in Guangzhou in the People's Republic of China (P.R.C.), along with medication use and consultations with physicians over the 14 days preceding data collection. Female doctors were, on average, ten years older than male doctors. Nurses (all female) were comparable to male doctors in terms of age. Current and general subjective health, and job satisfaction differed between doctors and nurses. Nurses were less satisfied than doctors and reported poorer perceived health, until gender and age were controlled. Female doctors had poorer ratings of general and current subjective health and lower job satisfaction than their male colleagues. Path analysis tested whether lower job satisfaction leads to decrements in perceived current health which in turn increased consultation with a physician and medication use. When male and female subjects were examined separately, job satisfaction was inversely related to consultation behaviour among males and positively related to perceived current health in both genders. Among females job satisfaction and consultation behaviour related to current perceived health but were not related to each other. The hypothesized path was upheld for nurses. Lack of power prevented the same path being significant for male or female doctors. In combination, doctors showed significant relationships between the four main variables studied.