Health Professions › General Health Professions

Patient Satisfaction in Healthcare

Works Count: 35388

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Description

This cluster of papers focuses on the factors influencing patient satisfaction with healthcare, including the measurement of patient satisfaction, public reporting of healthcare quality, the impact of patient experience on clinical outcomes, and strategies for quality improvement. It also explores the role of physician ratings, hospital care, and health system responsiveness in shaping patient satisfaction.

Keywords

Patient Satisfaction; Healthcare Quality; Public Reporting; Clinical Outcomes; Patient Experience; Quality Improvement; Physician Ratings; Hospital Care; Health System Responsiveness; Consumer Assessment

Patient satisfaction as an indicator of quality care.

1988-01-01

P D Cleary , Barbara J. McNeil

In this review of the theoretical and empirical work on patient satisfaction with care, the most consistent finding is that the characteristics of providers or organizations that result in more … In this review of the theoretical and empirical work on patient satisfaction with care, the most consistent finding is that the characteristics of providers or organizations that result in more "personal" care are associated with higher levels of satisfaction. Some studies suggest that more personal care will result in better communication and more patient involvement, and hence better quality of care, but the data on these issues are weak and inconsistent. Further research is needed to measure specific aspects of medical care and the ways in which patient reports can complement other sources of information about quality. In addition, more research on the determinants of satisfaction and the relationship between quality and satisfaction among hospitalized patients is recommended.

Linking primary care performance to outcomes of care.

1998-09-01

Dana Gelb Safran , Deborah A. Taira , William H. Rogers +3 more

Substantial research links many of the defining characteristics of primary care to important outcomes; yet little is known about the relative importance of each characteristic, and several characteristics have not … Substantial research links many of the defining characteristics of primary care to important outcomes; yet little is known about the relative importance of each characteristic, and several characteristics have not been examined. These analyses evaluate the relationship between seven defining elements of primary care (accessibility, continuity, comprehensiveness, integration, clinical interaction, interpersonal treatment, and trust) and three outcomes (adherence to physician's advice, patient satisfaction, and improved health status).Data were derived from a cross-sectional observational study of adults employed by the Commonwealth of Massachusetts (N = 7204). All patients completed a validated questionnaire, the Primary Care Assessment Survey. Regression methods were used to examine the association between each primary care characteristic (11 summary scales measuring 7 elements of care) and each outcome.Physicians' comprehensive ("whole person") knowledge of patients and patients' trust in their physician were the variables most strongly associated with adherence, and trust was the variable most strongly associated with patients' satisfaction with their physician. With other factors equal, adherence rates were 2.6 times higher among patients with whole-person knowledge scores in the 95th percentile compared with the 5th percentile (44.0% adherence vs 16.8% adherence, P < .001). The likelihood of complete satisfaction was 87.5% for those with 95th percentile trust scores compared with 0.4% for patients with 5th percentile trust scores (P < .001). The leading correlates of self-reported health improvements were integration of care, thoroughness of physical examinations, communication, comprehensive knowledge of patients, and trust (P < .001).Patients' trust in their physician and physicians' knowledge of patients are leading correlates of three important outcomes of care. The results are noteworthy in the context of pervasive changes in our nation's health care system that are widely viewed as threatening to the quality of physician-patient relationships.

Design and Implementation Content Validity Study: Development of an instrument for measuring Patient-Centered Communication

2015-06-01

Vahid Zamanzadeh , Akram Ghahramanian , Maryam Rassouli +3 more

The importance of content validity in the instrument psychometric and its relevance with reliability, have made it an essential step in the instrument development. This article attempts to give an … The importance of content validity in the instrument psychometric and its relevance with reliability, have made it an essential step in the instrument development. This article attempts to give an overview of the content validity process and to explain the complexity of this process by introducing an example.We carried out a methodological study conducted to examine the content validity of the patient-centered communication instrument through a two-step process (development and judgment). At the first step, domain determination, sampling (item generation) and instrument formation and at the second step, content validity ratio, content validity index and modified kappa statistic was performed. Suggestions of expert panel and item impact scores are used to examine the instrument face validity.From a set of 188 items, content validity process identified seven dimensions includes trust building (eight items), informational support (seven items), emotional support (five items), problem solving (seven items), patient activation (10 items), intimacy/friendship (six items) and spirituality strengthening (14 items). Content validity study revealed that this instrument enjoys an appropriate level of content validity. The overall content validity index of the instrument using universal agreement approach was low; however, it can be advocated with respect to the high number of content experts that makes consensus difficult and high value of the S-CVI with the average approach, which was equal to 0.93.This article illustrates acceptable quantities indices for content validity a new instrument and outlines them during design and psychometrics of patient-centered communication measuring instrument.

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The Organizational Trust Inventory (OTI): Development and Validation

1996-01-01

L. L. Cummings , Philip Bromiley

Development of the Patient Activation Measure (PAM): Conceptualizing and Measuring Activation in Patients and Consumers

2004-06-28

Judith H. Hibbard , Jean Stockard , Eldon R. Mahoney +1 more

Background. Controlling costs and achieving health care quality improvements require the participation of activated and informed consumers and patients. Objectives. We describe a process for conceptualizing and operationalizing what it … Background. Controlling costs and achieving health care quality improvements require the participation of activated and informed consumers and patients. Objectives. We describe a process for conceptualizing and operationalizing what it means to be “activated” and delineate the process we used to develop a measure for assessing “activation,” and the psychometric properties of that measure. Methods. We used the convergence of the findings from a national expert consensus panel and patient focus groups to define the concept and identify the domains of activation. These domains were operationalized by constructing a large item pool. Items were pilot‐tested and initial psychometric analysis performed using Rasch methodology. The third stage refined and extended the measure. The fourth stage used a national probability sample to assess the measure's psychometric performance overall and within different subpopulations. Study Sample. Convenience samples of patients with and without chronic illness, and a national probability sample ( N =1,515) are included at different stages in the research. Conclusions. The Patient Activation Measure is a valid, highly reliable, unidimensional, probabilistic Guttman‐like scale that reflects a developmental model of activation. Activation appears to involve four stages: (1) believing the patient role is important, (2) having the confidence and knowledge necessary to take action, (3) actually taking action to maintain and improve one's health, and (4) staying the course even under stress. The measure has good psychometric properties indicating that it can be used at the individual patient level to tailor intervention and assess changes.

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Is the professional satisfaction of general internists associated with patient satisfaction?

2000-02-01

Jennifer S. Haas , E. Francis Cook , Ann Louise Puopolo +3 more

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Toward a theory of patient satisfaction

1982-01-01

Susie Linder-Pelz

Assessment of patient satisfaction in activities of daily living using a modified stanford health assessment questionnaire

1983-11-01

Theodore Pincus , Jane A. Summey , Salvatore A. Soraci +2 more

Abstract Patient satisfaction in performing activities of daily living (ADL) was assessed by using a self‐administered questionnaire modified from the Stanford Health Assessment Questionnaire (HAQ). The HAQ includes questions to … Abstract Patient satisfaction in performing activities of daily living (ADL) was assessed by using a self‐administered questionnaire modified from the Stanford Health Assessment Questionnaire (HAQ). The HAQ includes questions to determine a patient's degree of difficulty and need for help and assistive devices in ADL. A modification of the HAQ (MHAQ) was developed to include questions concerning perceived patient satisfaction regarding the same ADL, along with perceived change in degree of difficulty. In order to add additional questions while maintaining the length of the questionnaire in a format suitable in routine care, the number of ADL included in the MHAQ was reduced from 20 to 8. Information regarding degree of difficulty derived from 8 questions in the MHAQ is comparable with that derived from 20 questions in the HAQ. The response of a patient that a specific activity is associated with difficulty in functional capacity was not inevitably associated with the absence of patient satisfaction; 43.7% of patients responding “with some difficulty” and 19.1% of patients responding “with much difficulty” expressed satisfaction with their functional capacity. A major determinant of expression of patient satisfaction was perceived change in difficulty: 81.4% of patients noting that their function was “less difficult now,” in contrast to 16.9% of patients responding “more difficult now,” expressed satisfaction. These studies suggest that data regarding patient satisfaction and perceived change in difficulty can be assessed to more completely characterize patients' functional status in ADL.

Assessment of client/patient satisfaction: Development of a general scale

1979-01-01

Daniel L. Larsen , C. Clifford Attkisson , William A. Hargreaves +1 more

Assessment of patient satisfaction: Development and refinement of a Service Evaluation Questionnaire

1983-01-01

Tuan D. Nguyen , C. Clifford Attkisson , Bruce L. Stegner

Defining and measuring patient satisfaction with medical care

1983-01-01

John E. Ware , Mary K. Snyder , Wendy Wright +1 more

Patient satisfaction: A valid concept?

1994-02-01

Brian Williams

Fundamental Elements of the Quality of Care: A Simple Framework

1990-03-01

Judith Bruce

This article argues for attention to a neglected dimension of family planning services--their quality. A framework for assessing quality from the client's perspective is offered, consisting of six parts (choice … This article argues for attention to a neglected dimension of family planning services--their quality. A framework for assessing quality from the client's perspective is offered, consisting of six parts (choice of methods, information given to clients, technical competence, interpersonal relations, follow-up and continuity mechanisms, and the appropriate constellation of services). The literature is reviewed regarding evidence that improvements in these various dimensions of care result in gains at the individual level; an even scarcer body of literature is reviewed for evidence of gains at the level of program efficiency and impact. A concluding section discusses how to make practical use of the framework and distinguishes three vantage points from which to view quality: the structure of the program, the service-giving process itself, and the outcome of care, particularly with respect to individual knowledge, behavior, and satisfaction with services.A framework for analyzing quality of family planning services is offered. Quality is a property that all programs have. The framework is made up of 6 parts: 1) choice of methods; 2) information given to clients; 3) technical competence; 4) interpersonal relations; 5) follow- up and continuity mechanisms; and 6) the appropriate "constellation" of services. Switching contraceptive methods is common. The ability of people to switch satisfies them. First use with temporary contraception methods is usually under 2 years. Having different contraceptive methods helps the program respond to the individual's need. Choice is not possible without an adequately developed delivery system. A positive relationship exists between a wide range of methods being available and contraceptive prevalence rates. Of Indonesian client who had reported not receiving the contraceptive method that they wanted, 85% discontinued within the year. Of those who got the method that they wanted, the discontinuation rate was 25%. Clients who wanted to practice contraception will be discouraged if not given information that can be used, or if the method is not available. How much contraception information should be given to the client? Enough so that they know that these are choices and that methods can be changed. There appears to be poor knowledge among clients of use, risks, and benefits of contraceptives. Many different monitoring technics are needed to analyze technical competence. The disparity between standards of competence in the West and what is found in the field should be addressed. Interpersonal relations is the affective content of the provider/client transaction. The characteristics of programs and clients have changed since the idea of follow-up was first brought about. The appropriate constellation of services should respond to clients rather than some artificial demarcation. Ways in which the framework may be used as an analytical and practical tool are discussed. Quality can be seen from the structure of the program, the service- giving process, and the outcome of care. The outcome of care consists of knowledge, behavior, and service satisfaction.

An Evaluation of Outcome from Intensive Care in Major Medical Centers

1986-03-01

William A. Knaus

We prospectively studied treatment and outcome in 5030 patients in intensive care units at 13 tertiary care hospitals. We stratified each hospital's patients by individual risk of death using diagnosis, … We prospectively studied treatment and outcome in 5030 patients in intensive care units at 13 tertiary care hospitals. We stratified each hospital's patients by individual risk of death using diagnosis, indication for treatment, and Acute Physiology and Chronic Health Evaluation (APACHE) II score. We then compared actual and predicted death rates using group results as the standard. One hospital had significantly better results with 69 predicted but 41 observed deaths (p < 0.0001). Another hospital had significantly inferior results with 58% more deaths than expected (p < 0.0001). These differences occurred within specific diagnostic categories, for medical patients alone and for medical and surgical patients combined, and were related more to the interaction and coordination of each hospital's intensive care unit staff than to the unit's administrative structure, amount of specialized treatment used, or the hospital's teaching status. Our findings support the hypothesis that the degree of coordination of intensive care significantly influences its effectiveness.

Patient-Physician Racial Concordance and the Perceived Quality and Use of Health Care

1999-05-10

Somnath Saha , Miriam Komaromy , Thomas D. Koepsell +1 more

<h3>Background</h3> Patients from racial and ethnic minority groups use fewer health care services and are less satisfied with their care than patients from the majority white population. These disparities may … <h3>Background</h3> Patients from racial and ethnic minority groups use fewer health care services and are less satisfied with their care than patients from the majority white population. These disparities may be attributable in part to racial or cultural differences between patients and their physicians. <h3>Objective</h3> To determine whether racial concordance between patients and physicians affects patients' satisfaction with and use of health care. <h3>Methods</h3> We analyzed data from the 1994 Commonwealth Fund's Minority Health Survey, a nationwide, telephone survey of noninstitutionalized adults. For the 2201 white, black, and Hispanic respondents who reported having a regular physician, we examined the association between patient-physician racial concordance and patients' ratings of their physicians, satisfaction with health care, reported receipt of preventive care, and reported receipt of needed medical care. <h3>Results</h3> Black respondents with black physicians were more likely than those with nonblack physicians to rate their physicians as excellent (adjusted odds ratio [OR], 2.40; 95% confidence interval [CI], 1.55-3.72) and to report receiving preventive care (adjusted OR, 1.74; 95% CI, 1.01-2.98) and all needed medical care (adjusted OR, 2.94; 95% CI, 1.10-7.87) during the previous year. Hispanics with Hispanic physicians were more likely than those with non-Hispanic physicians to be very satisfied with their health care overall (adjusted OR, 1.74; 95% CI, 1.01-2.99). <h3>Conclusions</h3> Our findings confirm the importance of racial and cultural factors in the patient-physician relationship and reaffirm the role of black and Hispanic physicians in caring for black and Hispanic patients. Improving cultural competence among physicians may enhance the quality of health care for minority populations. In the meantime, by reducing the number of underrepresented minorities entering the US physician workforce, the reversal of affirmative action policies may adversely affect the delivery of health care to black and Hispanic Americans.

Measuring Quality of Care

1996-09-26

Robert H. Brook , Elizabeth A. McGlynn , Paul D. Cleary

Until recently, we relied primarily on professional judgment to ensure that patients received high-quality medical care. Hospitals routinely monitored poor outcomes, such as deaths or infections, to identify ways to … Until recently, we relied primarily on professional judgment to ensure that patients received high-quality medical care. Hospitals routinely monitored poor outcomes, such as deaths or infections, to identify ways to improve the quality of care. In rare cases, medical societies reviewed the performance of physicians. However, monitoring of and improvement in quality were generally left to individual clinicians.This situation has changed dramatically. We have learned that practice patterns and the quality of medical care vary much more than many people had realized, our ability to measure the quality of care has advanced considerably, and clinicians are increasingly interested in . . .

Patient Satisfaction: What we Know about and What we Still Need to Explore

1993-03-01

Lea Aharony , Stephen Strasser

Article Commentary: Patient-Reported Outcomes (PROs) and Patient-Reported Outcome Measures (PROMs)

2013-01-01

Theresa Weldring , Sheree Smith

In recent years, there has been an increased focus on placing patients at the center of health care research and evaluating clinical care in order to improve their experience and … In recent years, there has been an increased focus on placing patients at the center of health care research and evaluating clinical care in order to improve their experience and ensure that research is both robust and of maximum value for the use of medicinal products, therapy, or health services. This paper provides an overview of patients’ involvement in clinical research and service evaluation along with its benefits and limitations. We describe and discuss patient-reported outcomes (PROs) and patient-reported outcome measures (PROMs), including the trends in current research. Both the patient-reported experiences measures (PREMs) and patient and public involvement (PPI) initiative for including patients in the research processes are also outlined. PROs provide reports from patients about their own health, quality of life, or functional status associated with the health care or treatment they have received. PROMs are tools and/or instruments used to report PROs. Patient report experiences through the use of PREMs, such as satisfaction scales, providing insight into the patients’ experience with their care or a health service. There is increasing international attention regarding the use of PREMS as a quality indicator of patient care and safety. This reflects the ongoing health service commitment of involving patients and the public within the wider context of the development and evaluation of health care service delivery and quality improvement.

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Is Doctor-Patient Race Concordance Associated with Greater Satisfaction with Care?

2002-09-01

Thomas A. LaVeist , Amani Nuru‐Jeter

We examined a national sample of African American, white, Hispanic, and Asian American respondents to test the hypothesis that doctor-patient race concordance is predictive of patient satisfaction. Our analysis examined … We examined a national sample of African American, white, Hispanic, and Asian American respondents to test the hypothesis that doctor-patient race concordance is predictive of patient satisfaction. Our analysis examined racial/ethnic differences in patient satisfaction among patients in multiple combinations of doctor-patient race/ethnicity pairs. Additionally, we outline the determinants of doctor-patient race concordance. The analysis used the 1994 Commonwealth Fund Minority Health Survey to construct a series of multivariate models. We found that for respondents in each race/ethnic group, patients who had a choice in the selection of their physician were more likely to be race concordant. Whites were more likely to be race concordant with their physician compared to African American, Hispanic, and Asian American respondents. Among each race/ethnic group, respondents who were race concordant reported greater satisfaction with their physician compared with respondents who were not race concordant. These findings suggest support for the continuation of efforts to increase the number of minority physicians, while placing greater emphasis on improving the ability of physicians to interact with patients who are not of their own race.

Patients' Perception of Hospital Care in the United States

2008-10-29

Ashish K. Jha , E. John Orav , Jie Zheng +1 more

Patients' perceptions of their care, especially in the hospital setting, are not well known. Data from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey provide a portrait … Patients' perceptions of their care, especially in the hospital setting, are not well known. Data from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey provide a portrait of patients' experiences in U.S. hospitals.

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The Medical Outcomes Study. An application of methods for monitoring the results of medical care

1989-08-18

Alvin R. Tarlov

The Medical Outcomes Study was designed to (1) determine whether variations in patient outcomes are explained by differences in system of care, clinician specialty, and clinicians' technical and interpersonal styles … The Medical Outcomes Study was designed to (1) determine whether variations in patient outcomes are explained by differences in system of care, clinician specialty, and clinicians' technical and interpersonal styles and (2) develop more practical tools for the routine monitoring of patient outcomes in medical practice. Outcomes included clinical end points; physical, social, and role functioning in everyday living; patients' perceptions of their general health and well-being; and satisfaction with treatment. Populations of clinicians (n = 523) were randomly sampled from different health care settings in Boston, Mass; Chicago, Ill; and Los Angeles, Calif. In the cross-sectional study, adult patients (n = 22 462) evaluated their health status and treatment. A sample of these patients (n = 2349) with diabetes, hypertension, coronary heart disease, and/or depression were selected for the longitudinal study. Their hospitalizations and other treatments were monitored and they periodically reported outcomes of care. At the beginning and end of the longitudinal study, Medical Outcomes Study staff performed physical examinations and laboratory tests. Results will be reported serially, primarily inThe Journal. (<i>JAMA</i>. 1989;262:925-930)

Patient satisfaction: A review of issues and concepts

1997-12-01

John Sitzia , Neil Wood

Patient sociodemographic characteristics as predictors of satisfaction with medical care: A meta-analysis

1990-01-01

Judith A. Hall , Michael C. Dornan

Systematic Review: The Evidence That Publishing Patient Care Performance Data Improves Quality of Care

2008-01-15

Constance H. Fung , Yee-Wei Lim , Soeren Mattke +2 more

Background: Previous reviews have shown inconsistent effects of publicly reported performance data on quality of care, but many new studies have become available in the 7 years since the last … Background: Previous reviews have shown inconsistent effects of publicly reported performance data on quality of care, but many new studies have become available in the 7 years since the last systematic review. Purpose: To synthesize the evidence for using publicly reported performance data to improve quality. Data Sources: Web of Science, MEDLINE, EconLit, and Wilson Business Periodicals (1999–2006) and independent review of articles (1986–1999) identified in a previous systematic review. Only sources published in English were included. Study Selection: Peer-reviewed articles assessing the effects of public release of performance data on selection of providers, quality improvement activity, clinical outcomes (effectiveness, patient safety, and patient-centeredness), and unintended consequences. Data Extraction: Data on study participants, reporting system or level, study design, selection of providers, quality improvement activity, outcomes, and unintended consequences were extracted. Data Synthesis: Forty-five articles published since 1986 (27 of which were published since 1999) evaluated the impact of public reporting on quality. Many focus on a select few reporting systems. Synthesis of data from 8 health plan–level studies suggests modest association between public reporting and plan selection. Synthesis of 11 studies, all hospital-level, suggests stimulation of quality improvement activity. Review of 9 hospital-level and 7 individual provider–level studies shows inconsistent association between public reporting and selection of hospitals and individual providers. Synthesis of 11 studies, primarily hospital-level, indicates inconsistent association between public reporting and improved effectiveness. Evidence on the impact of public reporting on patient safety and patient-centeredness is scant. Limitations: Heterogeneity made comparisons across studies challenging. Only peer-reviewed, English-language articles were included. Conclusion: Evidence is scant, particularly about individual providers and practices. Rigorous evaluation of many major public reporting systems is lacking. Evidence suggests that publicly releasing performance data stimulates quality improvement activity at the hospital level. The effect of public reporting on effectiveness, safety, and patient-centeredness remains uncertain.

Measuring Patient Benefit from Otorhinolaryngological Surgery and Therapy

1996-06-01

Ken Robinson , Stuart Gatehouse , George G. Browning

The Glasgow Benefit Inventory (GBI) is a measure of patient benefit developed especially for otorhinolaryngological (ORL) interventions. Patient benefit is the change in health status resulting from health care intervention. … The Glasgow Benefit Inventory (GBI) is a measure of patient benefit developed especially for otorhinolaryngological (ORL) interventions. Patient benefit is the change in health status resulting from health care intervention. The GBI was developed to be patient-oriented, to be maximally sensitive to ORL interventions, and to provide a common metric to compare benefit across different interventions. The GBI is an 18-item, postintervention questionnaire intended to be given to patients to fill in at home or in the outpatient clinic. In the first part of the paper, five different ORL interventions were retrospectively studied: middle ear surgery to improve hearing, provision of a cochlear implant, middle ear surgery to eradicate ear activity, rhinoplasty, and tonsillectomy. A criterion that was specific to the intervention was selected for each study, so that the patient outcome could be classified as above and below criterion. In all five interventions, the GBI was found to discriminate between above- and below-criterion outcomes. The second part of the paper reports on the results and implications of a factor analysis of patient responses. The factor structure was robust across the study, and so led to the construction of subscales. These subscales yield a profile score that provides information on the different types of patient benefit resulting from ORL interventions. The GBI is sensitive to the different ORL interventions, yet is sufficiently general to enable comparison between each pair of interventions. It provides a profile score, which enables further breakdown of results. As it provides a patient-oriented common metric, it is anticipated that the GBI will assist audit, research, and health policy planning.

The Cost of Satisfaction

2012-02-14

Joshua J. Fenton

Patient satisfaction is a widely used health care quality metric. However, the relationship between patient satisfaction and health care utilization, expenditures, and outcomes remains ill defined.We conducted a prospective cohort … Patient satisfaction is a widely used health care quality metric. However, the relationship between patient satisfaction and health care utilization, expenditures, and outcomes remains ill defined.We conducted a prospective cohort study of adult respondents (N = 51,946) to the 2000 through 2007 national Medical Expenditure Panel Survey, including 2 years of panel data for each patient and mortality follow-up data through December 31, 2006, for the 2000 through 2005 subsample (n = 36,428). Year 1 patient satisfaction was assessed using 5 items from the Consumer Assessment of Health Plans Survey. We estimated the adjusted associations between year 1 patient satisfaction and year 2 health care utilization (any emergency department visits and any inpatient admissions), year 2 health care expenditures (total and for prescription drugs), and mortality during a mean follow-up duration of 3.9 years.Adjusting for sociodemographics, insurance status, availability of a usual source of care, chronic disease burden, health status, and year 1 utilization and expenditures, respondents in the highest patient satisfaction quartile (relative to the lowest patient satisfaction quartile) had lower odds of any emergency department visit (adjusted odds ratio [aOR], 0.92; 95% CI, 0.84-1.00), higher odds of any inpatient admission (aOR, 1.12; 95% CI, 1.02-1.23), 8.8% (95% CI, 1.6%-16.6%) greater total expenditures, 9.1% (95% CI, 2.3%-16.4%) greater prescription drug expenditures, and higher mortality (adjusted hazard ratio, 1.26; 95% CI, 1.05-1.53).In a nationally representative sample, higher patient satisfaction was associated with less emergency department use but with greater inpatient use, higher overall health care and prescription drug expenditures, and increased mortality.

The Picker Patient Experience Questionnaire: development and validation using data from in-patient surveys in five countries

2002-10-01

Crispin Jenkinson

Objective. The purpose of this study was to develop and test a core set of questions to measure patients’ experiences of in-patient care. Questions were selected from the bank of … Objective. The purpose of this study was to develop and test a core set of questions to measure patients’ experiences of in-patient care. Questions were selected from the bank of items developed for use in in-patient surveys undertaken by the Picker Institute for the purposes of assessing the quality of care. Design. The data reported here come from surveys of patients who had attended acute care hospitals in five countries: the United Kingdom, Germany, Sweden, Switzerland, and the USA. Questionnaires were mailed to patients’ homes within 1 month of discharge, either to all patients, or to a random sample, discharged during a specified period. Sample. A total of 62 925 questionnaires were returned, with response rates of 65% (UK), 74% (Germany), 63% (Sweden), 52% (Switzerland), and 46% (USA). Results. Fifteen items were selected from the bank of questions included in the Picker in-patient questionnaires. These items have a high degree of face validity and when summed to an index they show a high degree of construct validity and internal reliability consistency. Discussion. Fifteen items derived from the longer form Picker in-patient survey have been found to provide a meaningful picture of patient experiences of health care, and constitute the 15-item Picker Patient Experience Questionnaire. These questions comprise a core set that should be measured in all in-patient facility surveys. The Picker Patient Experience Questionnaire represents a step forward in the measurement of patient experience as it provides a core set of questions around which further optional modules may be added. Scores are easy to interpret and actionable. Conclusion. This small set of questions could be incorporated into in-patient surveys in different settings, enabling the comparison of hospital performance and the establishment of national or international benchmarks.

The Public Release of Performance Data

2000-04-12

Martin Marshall , Paul G Shekelle , Sheila Leatherman +1 more

Information about the performance of hospitals, health professionals, and health care organizations has been made public in the United States for more than a decade. The expected gains of public … Information about the performance of hospitals, health professionals, and health care organizations has been made public in the United States for more than a decade. The expected gains of public disclosure have not been made clear, and both the benefits and potential risks have received minimal empirical investigation.To summarize the empirical evidence concerning public disclosure of performance data, relate the results to the potential gains, and identify areas requiring further research.A literature search was conducted on MEDLINE and EMBASE databases for articles published between January 1986 and October 1999 in peer-reviewed journals. Review of citations, public documents, and expert advice was conducted to identify studies not found in the electronic databases.Descriptive, observational, or experimental evaluations of US reporting systems were selected for inclusion.Included studies were organized based on use of public data by consumers, purchasers, physicians, and hospitals; impact on quality of care outcomes; and costs.Seven US reporting systems have been the subject of published empirical evaluations. Descriptive and observational methods predominate. Consumers and purchasers rarely search out the information and do not understand or trust it; it has a small, although increasing, impact on their decision making. Physicians are skeptical about such data and only a small proportion makes use of it. Hospitals appear to be most responsive to the data. In a limited number of studies, the publication of performance data has been associated with an improvement in health outcomes.There are several potential gains from the public disclosure of performance data, but use of the information by provider organizations for quality improvement may be the most productive area for further research.

Patient satisfaction in primary health care: A literature review and analysis

1983-01-01

Gregory C. Pascoe

Examining the Role of Patient Experience Surveys in Measuring Health Care Quality

2014-07-15

Rebecca Anhang Price , Marc N. Elliott , Alan M. Zaslavsky +5 more

Patient care experience surveys evaluate the degree to which care is patient-centered. This article reviews the literature on the association between patient experiences and other measures of health care quality. … Patient care experience surveys evaluate the degree to which care is patient-centered. This article reviews the literature on the association between patient experiences and other measures of health care quality. Research indicates that better patient care experiences are associated with higher levels of adherence to recommended prevention and treatment processes, better clinical outcomes, better patient safety within hospitals, and less health care utilization. Patient experience measures that are collected using psychometrically sound instruments, employing recommended sample sizes and adjustment procedures, and implemented according to standard protocols are intrinsically meaningful and are appropriate complements for clinical process and outcome measures in public reporting and pay-for-performance programs.

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Current Concepts in Validity and Reliability for Psychometric Instruments: Theory and Application

2006-01-28

David A. Cook , Thomas J. Beckman

Predictors of patient satisfaction

2001-02-01

Jeffrey L. Jackson , Judith Chamberlin , Kurt Kroenke

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Public Reporting and Pay for Performance in Hospital Quality Improvement

2007-01-26

Peter K. Lindenauer , Denise Remus , Sheila H. Roman +4 more

Public reporting and pay for performance are intended to accelerate improvements in hospital care, yet little is known about the benefits of these methods of providing incentives for improving care.We … Public reporting and pay for performance are intended to accelerate improvements in hospital care, yet little is known about the benefits of these methods of providing incentives for improving care.We measured changes in adherence to 10 individual and 4 composite measures of quality over a period of 2 years at 613 hospitals that voluntarily reported information about the quality of care through a national public-reporting initiative, including 207 facilities that simultaneously participated in a pay-for-performance demonstration project funded by the Centers for Medicare and Medicaid Services; we then compared the pay-for-performance hospitals with the 406 hospitals with public reporting only (control hospitals). We used multivariable modeling to estimate the improvement attributable to financial incentives after adjusting for baseline performance and other hospital characteristics.As compared with the control group, pay-for-performance hospitals showed greater improvement in all composite measures of quality, including measures of care for heart failure, acute myocardial infarction, and pneumonia and a composite of 10 measures. Baseline performance was inversely associated with improvement; in pay-for-performance hospitals, the improvement in the composite of all 10 measures was 16.1% for hospitals in the lowest quintile of baseline performance and 1.9% for those in the highest quintile (P<0.001). After adjustments were made for differences in baseline performance and other hospital characteristics, pay for performance was associated with improvements ranging from 2.6 to 4.1% over the 2-year period.Hospitals engaged in both public reporting and pay for performance achieved modestly greater improvements in quality than did hospitals engaged only in public reporting. Additional research is required to determine whether different incentives would stimulate more improvement and whether the benefits of these programs outweigh their costs.

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Good practice in the conduct and reporting of survey research

2003-05-01

Kristen D. Kelley

Survey research is sometimes regarded as an easy research approach. However, as with any other research approach and method, it is easy to conduct a survey of poor quality rather … Survey research is sometimes regarded as an easy research approach. However, as with any other research approach and method, it is easy to conduct a survey of poor quality rather than one of high quality and real value. This paper provides a checklist of good practice in the conduct and reporting of survey research. Its purpose is to assist the novice researcher to produce survey work to a high standard, meaning a standard at which the results will be regarded as credible. The paper first provides an overview of the approach and then guides the reader step-by-step through the processes of data collection, data analysis, and reporting. It is not intended to provide a manual of how to conduct a survey, but rather to identify common pitfalls and oversights to be avoided by researchers if their work is to be valid and credible.

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A systematic review of evidence on the links between patient experience and clinical safety and effectiveness

2013-01-01

Cathal Doyle , Laura Lennox , Derek Bell

To explore evidence on the links between patient experience and clinical safety and effectiveness outcomes. To explore evidence on the links between patient experience and clinical safety and effectiveness outcomes.

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Attitudes about Racism, Medical Mistrust, and Satisfaction with Care among African American and White Cardiac Patients

2000-11-01

Thomas A. LaVeist , Kim J. Nickerson , Janice Bowie

The authors examine determinants of satisfaction with medical care among 1,784 (781 African American and 1,003 white) cardiac patients. Patient satisfaction was modeled as a function of predisposing factors (gender, … The authors examine determinants of satisfaction with medical care among 1,784 (781 African American and 1,003 white) cardiac patients. Patient satisfaction was modeled as a function of predisposing factors (gender, age, medical mistrust, and perception of racism) and enabling factors (medical insurance). African Americans reported less satisfaction with care. Although both black and white patients tended not to endorse the existence of racism in the medical care system, African American patients were more likely to perceive racism. African American patients were significantly more likely to report mistrust. Multivariate analysis found that the perception of racism and mistrust of the medical care system led to less satisfaction with care. When perceived racism and medical mistrust were controlled, race was no longer a significant predictor of satisfaction.

Factors Influencing Healthcare Service Quality

2014-01-01

Ali Mohammad Mosadeghrad

The main purpose of this study was to identify factors that influence healthcare quality in the Iranian context.Exploratory in-depth individual and focus group interviews were conducted with 222 healthcare stakeholders … The main purpose of this study was to identify factors that influence healthcare quality in the Iranian context.Exploratory in-depth individual and focus group interviews were conducted with 222 healthcare stakeholders including healthcare providers, managers, policy-makers, and payers to identify factors affecting the quality of healthcare services provided in Iranian healthcare organisations.Quality in healthcare is a production of cooperation between the patient and the healthcare provider in a supportive environment. Personal factors of the provider and the patient, and factors pertaining to the healthcare organisation, healthcare system, and the broader environment affect healthcare service quality. Healthcare quality can be improved by supportive visionary leadership, proper planning, education and training, availability of resources, effective management of resources, employees and processes, and collaboration and cooperation among providers.This article contributes to healthcare theory and practice by developing a conceptual framework that provides policy-makers and managers a practical understanding of factors that affect healthcare service quality.

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Patients' experiences and satisfaction with health care: results of a questionnaire study of specific aspects of care

2002-12-01

C Jenkinson

<b>Objective:</b> To determine what aspects of healthcare provision are most likely to influence satisfaction with care and willingness to recommend hospital services to others and, secondly, to explore the extent … <b>Objective:</b> To determine what aspects of healthcare provision are most likely to influence satisfaction with care and willingness to recommend hospital services to others and, secondly, to explore the extent to which satisfaction is a meaningful indicator of patient experience of healthcare services. <b>Design:</b> Postal survey of a sample of patients who underwent a period of inpatient care. Patients were asked to evaluate their overall experience of this episode of care and to complete the Picker Inpatient Survey questionnaire on specific aspects of their care. <b>Sample:</b> Patients aged 18 and over presenting at five hospitals within one NHS trust in Scotland. <b>Method:</b> 3592 questionnaires were mailed to patients’ homes within 1 month of discharge from hospital during a 12 month period. Two reminders were sent to non-responders; 2249 (65%) questionnaires were returned. <b>Results:</b> Almost 90% of respondents indicated that they were satisfied with their period of inpatient care. Age and overall self-assessed health were only weakly associated with satisfaction. A multiple linear regression indicated that the major determinants of patient satisfaction were physical comfort, emotional support, and respect for patient preferences. However, many patients who reported their satisfaction with the care they received also indicated problems with their inpatient care as measured on the Picker Inpatient Survey; 55% of respondents who rated their inpatient episode as “excellent” indicated problems on 10% of the issues measured on the Picker questionnaire. <b>Discussion:</b> The evidence suggests that patient satisfaction scores present a limited and optimistic picture. Detailed questions about specific aspects of patients’ experiences are likely to be more useful for monitoring the performance of various hospital departments and wards and could point to ways in which delivery of health care could be improved.

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Patient Satisfaction Survey as a Tool Towards Quality Improvement

2014-01-15

Rashid Al-Abri , Amina Al-Balushi

Over the past 20 years, patient satisfaction surveys have gained increasing attention as meaningful and essential sources of information for identifying gaps and developing an effective action plan for quality … Over the past 20 years, patient satisfaction surveys have gained increasing attention as meaningful and essential sources of information for identifying gaps and developing an effective action plan for quality improvement in healthcare organizations.However, there are very few published studies reporting of the improvements resulting from feedback information of patient satisfaction surveys, and in most cases, these studies are contradictory in their findings.This article investigates in-depth a number of research studies that critically discuss the relationship of dependent and independent influential attributes towards overall patient satisfaction in addition to its impact on the quality improvement process of healthcare organizations.

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How Good Is the Quality of Health Care in the United States?

1998-12-01

Mark A. Schuster , Elizabeth A. McGlynn , Robert H. Brook

Studies over the past decade show that some people are receiving more care than they need, and some are receiving less. Simple averages from a number of studies indicate that … Studies over the past decade show that some people are receiving more care than they need, and some are receiving less. Simple averages from a number of studies indicate that 50 percent of people received recommended preventive care; 70 percent, recommended acute care; 30 percent, contraindicated acute care; 60 percent, recommended chronic care; and 20 percent, contraindicated chronic care. These studies strongly suggest that the care delivered in the United States often does not meet professional standards. Efforts to measure quality and report routinely on the results to the public at large would allow more definitive assessments of the status of the nation's health care and would enable us to single out the areas in need of improvement.

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Validation of a general measure of treatment satisfaction, the Treatment Satisfaction Questionnaire for Medication (TSQM), using a national panel study of chronic disease.

2004-01-01

Mark J. Atkinson , Anusha Sinha , Steven Hass +4 more

The objective of this study was to develop and psychometrically evaluate a general measure of patients' satisfaction with medication, the Treatment Satisfaction Questionnaire for Medication (TSQM). The content and format … The objective of this study was to develop and psychometrically evaluate a general measure of patients' satisfaction with medication, the Treatment Satisfaction Questionnaire for Medication (TSQM). The content and format of 55 initial questions were based on a formal conceptual framework, an extensive literature review, and the input from three patient focus groups. Patient interviews were used to select the most relevant questions for further evaluation (n = 31). The psychometric performance of items and resulting TSQM scales were examined using eight diverse patient groups (arthritis, asthma, major depression, type I diabetes, high cholesterol, hypertension, migraine, and psoriasis) recruited from a national longitudinal panel study of chronic illness (n = 567). Participants were then randomized to complete the test items using one of two alternate scaling methods (Visual Analogue vs. Likert-type). A factor analysis (principal component extraction with varimax rotation) of specific items revealed three factors (Eigenvalues > 1.7) explaining 75.6% of the total variance; namely Side effects (4 items, 28.4%, Cronbach's Alpha = .87), Effectiveness (3 items, 24.1%, Cronbach's Alpha = .85), and Convenience (3 items, 23.1%, Cronbach's Alpha = .87). A second factor analysis of more generally worded items yielded a Global Satisfaction scale (3 items, Eigenvalue = 2.3, 79.1%, Cronbach's Alpha = .85). The final four scales possessed good psychometric properties, with the Likert-type scaling method performing better than the VAS approach. Significant differences were found on the TSQM by the route of medication administration (oral, injectable, topical, inhalable), level of illness severity, and length of time on medication. Regression analyses using the TSQM scales accounted for 40–60% of variation in patients' ratings of their likelihood to persist with their current medication. The TSQM is a psychometrically sound and valid measure of the major dimensions of patients' satisfaction with medication. Preliminary evidence suggests that the TSQM may also be a good predictor of patients' medication adherence across different types of medication and patient populations.

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The measurement of satisfaction with healthcare: implications for practice from a systematic review of the literature

2002-01-01

Rosemary Crow , Heather Gage , S Hampson +4 more

T he NHS R&D Health Technology Assessment (HTA) Programme was set up in 1993 to ensure that high-quality research information on the costs, effectiveness and broader impact of health technologies … T he NHS R&D Health Technology Assessment (HTA) Programme was set up in 1993 to ensure that high-quality research information on the costs, effectiveness and broader impact of health technologies is produced in

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Systematic review of studies of patient satisfaction with telemedicine

2000-06-03

Frances S Mair

<h3>Abstract</h3> <b>Objective:</b> To review research into patient satisfaction with teleconsultation, specifically clinical consultations between healthcare providers and patients involving real time interactive video. <b>Design:</b> Systematic review of telemedicine satisfaction studies. … <h3>Abstract</h3> <b>Objective:</b> To review research into patient satisfaction with teleconsultation, specifically clinical consultations between healthcare providers and patients involving real time interactive video. <b>Design:</b> Systematic review of telemedicine satisfaction studies. Electronic databases searched include Medline, Embase, Science Citation Index, Social Sciences Citation Index, Arts and Humanities Citation Index, and the TIE (Telemedicine Information Exchange) database. <b>Subjects:</b> Studies conducted worldwide and published between 1966 and 1998. <b>Main outcome measures:</b> Quality of evidence about patient satisfaction. <b>Results:</b> 32 studies were identified. Study methods used were simple survey instruments (26 studies), exact methods not specified (5), and qualitative methods (1). Study designs were randomised controlled trial (1 trial); random patient selection (2); case-control (1); and selection criteria not specified or participants represented consecutive referrals, convenience samples, or volunteers (28). Sample sizes were20 (10 trials),100 (14), >100 (7), and not specified (1). All studies reported good levels of patient satisfaction. Qualitative analysis revealed methodological problems with all the published work. Even so, important issues were highlighted that merit further investigation. There is a paucity of data examining patients9 perceptions or the effects of this mode of healthcare delivery on the interaction between providers and clients. <b>Conclusions:</b> Methodological deficiencies (low sample sizes, context, and study designs) of the published research limit the generalisability of the findings. The studies suggest that teleconsultation is acceptable to patients in a variety of circumstances, but issues relating to patient satisfaction require further exploration from the perspective of both clients and providers.

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Patient-Centered Care and Outcomes

2012-11-20

Cheryl Rathert , Mary D. Wyrwich , Suzanne Austin Boren

Patient-centered care (PCC) has been studied for several decades. Yet a clear definition of PCC is lacking, as is an understanding of how specific PCC processes relate to patient outcomes. … Patient-centered care (PCC) has been studied for several decades. Yet a clear definition of PCC is lacking, as is an understanding of how specific PCC processes relate to patient outcomes. We conducted a systematic review of the PCC literature to examine the evidence for PCC and outcomes. Three databases were searched for all years through September 2012. We retained 40 articles for the analysis. Results found mixed relationships between PCC and clinical outcomes, that is, some studies found significant relationships between specific elements of PCC and outcomes but others found no relationship. There was stronger evidence for positive influences of PCC on satisfaction and self-management. Future research should examine specific dimensions of PCC and how they relate to technical care quality, particularly some dimensions that have not been studied extensively. Future research also should identify moderating and mediating variables in the PPC–outcomes relationship.

Patient compliance with paper and electronic diaries

2003-04-01

Arthur A. Stone , Saul Shiffman , Joseph E. Schwartz +2 more

Impact of Relational Coordination on Quality of Care, Postoperative Pain and Functioning, and Length of Stay

2000-08-01

Jody Hoffer Gittell , Kathleen M. Fairfield , Benjamin Bierbaum +7 more

Health care organizations face pressures from patients to improve the quality of care and clinical outcomes, as well as pressures from managed care to do so more efficiently. Coordination, the … Health care organizations face pressures from patients to improve the quality of care and clinical outcomes, as well as pressures from managed care to do so more efficiently. Coordination, the management of task interdependencies, is one way that health care organizations have attempted to meet these conflicting demands.The objectives of this study were to introduce the concept of relational coordination and to determine its impact on the quality of care, postoperative pain and functioning, and the length of stay for patients undergoing an elective surgical procedure. Relational coordination comprises frequent, timely, accurate communication, as well as problem-solving, shared goals, shared knowledge, and mutual respect among health care providers.Relational coordination was measured by a cross-sectional questionnaire of health care providers. Quality of care was measured by a cross-sectional postoperative questionnaire of total hip and knee arthroplasty patients. On the same questionnaire, postoperative pain and functioning were measured by the WOMAC osteoarthritis instrument. Length of stay was measured from individual patient hospital records.The subjects for this study were 338 care providers and 878 patients who completed questionnaires from 9 hospitals in Boston, MA, New York, NY, and Dallas, TX, between July and December 1997.Quality of care, postoperative pain and functioning, and length of acute hospital stay.Relational coordination varied significantly between sites, ranging from 3.86 to 4.22 (P <0.001). Quality of care was significantly improved by relational coordination (P <0.001) and each of its dimensions. Postoperative pain was significantly reduced by relational coordination (P = 0.041), whereas postoperative functioning was significantly improved by several dimensions of relational coordination, including the frequency of communication (P = 0.044), the strength of shared goals (P = 0.035), and the degree of mutual respect (P = 0.030) among care providers. Length of stay was significantly shortened (53.77%, P <0.001) by relational coordination and each of its dimensions.Relational coordination across health care providers is associated with improved quality of care, reduced postoperative pain, and decreased lengths of hospital stay for patients undergoing total joint arthroplasty. These findings support the design of formal practices to strengthen communication and relationships among key caregivers on surgical units.

The measurement of patient satisfaction

1992-09-01

Roy Carr‐Hill

Many applied health service researchers launch into patient satisfaction surveys without realizing the complexity of the task. This paper identifies the difficulties involved in executing patient satisfaction surveys. The recent … Many applied health service researchers launch into patient satisfaction surveys without realizing the complexity of the task. This paper identifies the difficulties involved in executing patient satisfaction surveys. The recent revival of interest in 'satisfaction' and disagreements over the meaningfulness of a unitary concept itself are outlined, and the various perspectives and definitions of the components of satisfaction are explored. The difficulties of developing a comprehensive conceptual model are considered, and the issues involved in designing patient satisfaction surveys--and the disasters that occur when these issues are ignored--are then set out. The potential cost-effectiveness of qualitative techniques is discussed, and the paper concludes by discussing how health care management systems could more effectively absorb the findings of patient satisfaction surveys.

The Patient Experience and Health Outcomes

2012-12-26

Matthew P. Manary , William Boulding , Richard Staelin +1 more

Interview with Susan Edgman-Levitan on patient-experience measures and their relationship to health outcomes. (00:00)Download Despite criticism of patient-satisfaction measures, patient-experience surveys that are designed and administered appropriately provide robust measures … Interview with Susan Edgman-Levitan on patient-experience measures and their relationship to health outcomes. (00:00)Download Despite criticism of patient-satisfaction measures, patient-experience surveys that are designed and administered appropriately provide robust measures of the quality of health care and offer insight into a dimension that's otherwise difficult to measure objectively.

Determinants of patient satisfaction: a systematic review

2016-03-23

Enkhjargal Batbaatar , Javkhlanbayar Dorjdagva , Ariunbat Luvsannyam +2 more

Aim: A large number of studies have addressed the detection of patient satisfaction determinants, and the results are still inconclusive. Furthermore, it is known that contradicting evidence exists across patient … Aim: A large number of studies have addressed the detection of patient satisfaction determinants, and the results are still inconclusive. Furthermore, it is known that contradicting evidence exists across patient satisfaction studies. This article is the second part of a two-part series of research with a goal to review a current conceptual framework of patient satisfaction for further operationalisation procedures. The aim of this work was to systematically identify and review evidence regarding determinants of patient satisfaction between 1980 and 2014, and to seek the reasons for contradicting results in relationships between determinants and patient satisfaction in the literature to design a further robust measurement system for patient satisfaction. Method: This systematic review followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. The search was conducted in PubMed, CINAHL, and Scopus in October 2014. Studies published in full in peer reviewed journals between January 1980 and August 2014 and in the English language were included. We included 109 articles for the synthesis. Results: We found several number of determinants of patient satisfaction investigated in a wide diversity of studies. However, study results were varied due to no globally accepted formulation of patient satisfaction and measurement system. Conclusions: Health care service quality indicators were the most influential determinants of patient satisfaction across the studies. Among them, health providers’ interpersonal care quality was the essential determinant of patient satisfaction. Sociodemographic characteristics were the most varied in the review. The strength and directions of associations with patient satisfaction were found inconsistent. Therefore, person-related characteristics should be considered to be the potential determinants and confounders simultaneously. The selected studies were not able to show all potential characteristics which may have had effects on satisfaction. There is a need for more studies on how cultural, behavioural, and socio-demographic differences affect patient satisfaction, using a standardised questionnaire.

Relationship Between Clerical Burden and Characteristics of the Electronic Environment With Physician Burnout and Professional Satisfaction

2016-06-28

Tait D. Shanafelt , Liselotte N. Dyrbye , Christine A. Sinsky +4 more

REGIONAL DIFFERENCES IN PATIENT SATISFACTION WITH NURSING CARE QUALITY IN ALBANIA

2025-06-26

| Journal of Management Sciences and Applications

This study investigates patient satisfaction with nursing care in six regional hospitals in Albania using the validated Patient Satisfaction with Nursing Care Quality Questionnaire (PSNCQQ). The findings reveal marked regional … This study investigates patient satisfaction with nursing care in six regional hospitals in Albania using the validated Patient Satisfaction with Nursing Care Quality Questionnaire (PSNCQQ). The findings reveal marked regional disparities, with satisfaction rates ranging from 26.8% in Fier to 77.5% in Lezhë. Higher satisfaction was observed in hospitals with better nurse-patient ratios and organizational practices, while lower scores reflected systemic challenges including understaffing and limited oversight. Sociodemographic differences also emerged, with lower satisfaction reported among patients with higher education, recent hospitalizations, or poor self-rated health. These insights underscore the critical need to embed patient feedback into national performance monitoring systems. Benchmarking satisfaction across institutions can support targeted reforms, enhance nursing quality, and promote equitable healthcare delivery. The study highlights the role of structured satisfaction assessments as tools for governance and accountability in transitional health systems.

Impact of an Educational Intervention on Knowledge and Attitudes Regarding Prevention of Central Line Infection Among <scp>ICU</scp> Nurses

2025-06-25

Majdi M. Alzoubi , Duaa Abu Assaf , Khalid Al‐Mugheed +3 more | Nursing in Critical Care

ABSTRACT Background Central line‐associated bloodstream infections (CLABSI) represent a significant threat to patient safety, particularly in Intensive Care Units (ICUs). Despite evidence‐based guidelines for CLABSI prevention, adherence remains suboptimal, particularly … ABSTRACT Background Central line‐associated bloodstream infections (CLABSI) represent a significant threat to patient safety, particularly in Intensive Care Units (ICUs). Despite evidence‐based guidelines for CLABSI prevention, adherence remains suboptimal, particularly among ICU nurses in Jordan. Aim To assess the impact of an educational intervention on ICU nurses' knowledge and attitudes regarding the prevention of CLABSI. Study Design One‐group pre‐test–post‐test quasi‐experimental design was employed. Fifty‐two ICU nurses from two Jordanian hospitals participated. Data were collected using a self‐reported questionnaire assessing knowledge and attitudes towards CLABSI prevention before and after the intervention. Statistical analyses were descriptive statistics and paired t ‐tests to evaluate the intervention's effectiveness on knowledge and attitudes. Results The results indicate a significant improvement in knowledge scores following the educational intervention. The mean knowledge score increased from 37.34 ± 16.95 before the intervention to 79.49 ± 21.73 after the intervention, with a mean difference of 42.15 (95% CI: 35.29 to 49.01), p < 0.001. In contrast, there was no significant change in attitude scores. The pre‐intervention mean attitude score was 16.44 ± 4.16, while the post‐intervention score was 16.38 ± 3.46, with a mean difference of −0.06 (95% CI: −1.06 to 0.94), p = 0.938. Conclusion The educational intervention effectively improved ICU nurses' knowledge regarding CLABSI prevention but did not significantly change their attitudes. Tailoring interventions to demographic characteristics may further enhance their effectiveness and contribute to better patient outcomes and healthcare quality. Relevance to Clinical Practice ICU nurses require ongoing, comprehensive training programmes that encompass both knowledge enhancement and attitude development.

Comprehensive Assessment of the Patient Journey and Service Quality: A Multi-Dimensional Study of Hospital Experiences in Tier Two City

2025-06-25

Sandesh Kumar Sharma | Journal of Informatics Education and Research

Understanding what influences patients’ decisions is crucial for healthcare management to enhance the overall patient experience and satisfaction. Patients consider several factors when choosing a healthcare organization, including ambiance, accessibility, … Understanding what influences patients’ decisions is crucial for healthcare management to enhance the overall patient experience and satisfaction. Patients consider several factors when choosing a healthcare organization, including ambiance, accessibility, affordability, and quality. This research analyzes various factors such as waiting times, reputation, affordability, accessibility, sanitation, quality, and the services provided. A cross-sectional study was conducted with 277 participants to evaluate hospital service quality. The findings indicate that to meet patient expectations, healthcare organization must prioritize accessibility, affordability, and sanitation. Additionally, they should maintain a strong reputation and minimize wait times. Healthcare organizations should take into account the preferences of the patients they aim to serve, which requires a thorough analysis of the data provided in the study.

Validación de una escala rápida de satisfacción de usuarios del servicio de imagenología

2025-06-24

Álvaro J. Montiel‐Jarquín , Arturo García-Galicia , Diana López-García +6 more | Anales Médicos de la Asociación Médica del Centro Médico ABC

An Audit Investigating the Appropriateness of Referrals to the Dental Sleep Clinic at Guy's Hospital

2025-06-24

Rochelle Garner , J. M. Gill , Seema Imantabari | International Journal of Oral and Maxillofacial Surgery

Patient Satisfaction With Dental Services Provided by Dental Interns at Gulf Medical University Dental Training Hospital

2025-06-22

Lara Kanjee , Marwah Yakoop Abdullah , Noor Alyasiri +1 more | Cureus

Patients' Views and Expectations of Consultations in Primary Care in Malaysia: A Qualitative Study

2025-06-22

Magdy Omar , Nurul'Ain Binti Hamdan , Afif Bin Mohd Amirruddin +1 more | Cureus

Are oncologists and their patients on the same page? - Exploring clinician–patient agreement in performance status reporting

2025-06-21

Nandini Devi Rajan , Praveen Kumar Shenoy , Mohandoss Murugesan +5 more | Supportive Care in Cancer

FAMCARE: A Tool for Measuring Effectiveness of End-of-Life Care

2025-06-20

Sila Tonboot , Pantitra Singkheaw , Attakorn Raksasataya +3 more | Journal of Community Development Research (Humanities and Social Sciences)

This comprehensive narrative review examines FAMCARE as a measurement tool for evaluating the effectiveness of end-of-life care, exploring its development, psychometric properties, applications across various healthcare setting, and impact on … This comprehensive narrative review examines FAMCARE as a measurement tool for evaluating the effectiveness of end-of-life care, exploring its development, psychometric properties, applications across various healthcare setting, and impact on quality improvement initiatives. Originally developed for assessing family satisfaction in advanced cancer care, FAMCARE has evolved into various validated versions (FAMCARE-2, FAMCARE-6, FAMCARE-P13) adapted for different healthcare settings and cultural contexts. The tool demonstrates robust psychometric properties, with high internal consistency (Cronbach’s alpha 0.93-0.96) across multiple studies and strong cross-cultural validity through successful adaptations in various languages and healthcare systems. Review of its implementation across diverse settings, including hospice, hospital-based palliative care units, home-based care, and oncology departments, reveals its effectiveness in measuring and improving care quality. The tool’s multidimensional structure, encompassing information provision, availability of care, physical patient care, and psychosocial support, provides comprehensive insights into family satisfaction with end-of-life care. However, potential limitations including ceiling effects and retrospective assessment challenges have been identified. This review also highlights FAMCARE’s significant contribution to quality improvement initiatives, particularly in enhancing communication skills training, symptom management, and psychosocial support services. Future directions for FAMCARE development include real-time assessment capabilities, personalization options, and integration with emerging healthcare technologies. These findings underscore FAMCARE’s value as both a research instrument and a practical tool for improving end-of-life care quality, while identifying areas for future refinement to ensure its continued relevance in evolving healthcare landscapes.

Quality assessment of inpatient antimicrobial therapy using a multi-criteria decision analysis model

2025-06-20

M D Varyukhina , В. А. Лемешко , Stanislav S Otstavnov | Medical Technologies Assessment and Choice

Objective. To develop an integral antimicrobial therapy quality index (AMTQI) using the multi-criteria decision analysis (MCDA) methodology and to validate the calculation models in an in-hospital setting. Materials and methods. … Objective. To develop an integral antimicrobial therapy quality index (AMTQI) using the multi-criteria decision analysis (MCDA) methodology and to validate the calculation models in an in-hospital setting. Materials and methods. Based on the content analysis and expert questionnaires, a set of criteria for assessing the quality of antimicrobial therapy (AMT), assessment scales were developed, and weight coefficients (WC) were calculated using the direct weighting (DW) method and the indirect method of Potentially All Pairwise RanKings of all possible Alternatives (PAPRIKA). Based on the obtained WCs, a simple linear aggregation model (SLAM) with two sets of WCs (DW and PAPRIKA) and a multi-attribute value theory (MAVT) with a set of PAPRIKA WCs were created. Model validation and scenario sensitivity analysis were performed on 10 case histories of patients in an inpatient department. Results. A list of 12 AMT quality criteria was created; the WC criteria using DW were comparable, while the PAPRIKA method showed more differences between the WCs. When calculating AMTQI, the comparability of the assessment for each AMT case was found (mean SLAM (DW) value was 73.3±26.2, SLAM (PAPRIKA) 73.0±24.9, and MAVT (PAPRIKA) 72.1±25.1 points). The result rankings were the same in the SLAM models and differed in the two patients in the MAVT. All models demonstrated robustness for 8 of the 12 criteria in the scenario sensitivity analysis. Conclusion. A MCDA method can be used to develop a model of an AMTQI based on a comprehensive set of universal criteria, with the SLAM and MAVT models appearing comparable. However, the results obtained need to be confirmed using more data. The AMTQI can be used in the internal and external audit of quality control of medical care in healthcare organizations.

What Do Patients Want? Outcome Measures in a Diverse World

2025-06-20

Ashley L. Titan , Elspeth Hill , Camille Brenac +7 more | Journal of Hand Surgery Global Online

Assessing Physicians’ and Nurses’ Awareness of Health Educators’ Roles and Its Impact on Patient Experience in Healthcare Settings: A Cross-sectional Study in Saudi Arabia

2025-06-19

Nawaf Alnuwaysir , Bayader A. Alotaiby , Lujain Bin Amer +2 more | Cureus

Evaluating the Quality of Patient Care at Trust Hospital: Nursing Staff’s Perspective in Greater Accra, Ghana

2025-06-19

Moses Djan , Stephen Henry Afakorzi , Edward Kofi Sutherland | Nursing & Midwifery Research Journal

Background Ghana’s healthcare sector came under criticism regarding the quality of healthcare delivery, with issues relating to high-profile healthcare controversies, civil suits, and unfavorable patient outcomes due to medical incompetence. … Background Ghana’s healthcare sector came under criticism regarding the quality of healthcare delivery, with issues relating to high-profile healthcare controversies, civil suits, and unfavorable patient outcomes due to medical incompetence. Despite the implementation of quality health programs, quality culture is yet to be institutionalized, leading to poor ties between clinical care and public health at the district level, and unclear monitoring and governance mechanisms. These have resulted in quality approaches that have had no effect on patient satisfaction and health outcomes. Even though nurses devote more hours to patients than most healthcare staff and offer care to patients on a regular basis, the daily assessment of the care they provide to patients is conducted without a thorough understanding of what quality healthcare entails. This study aims at assessing the quality of healthcare service delivery from the nurses’ perspective in a healthcare facility. Materials and Methods This was a cross-sectional quantitative study carried out among 104 systematically selected nurses. A standard questionnaire designed in accordance with the Donabedian Model of Quality Care was administered, and a reliability analysis ( α ) was conducted to ensure internal validity and reliability of the items used to measure the constructs. The structure subscale consisted of 12 items ( α = 0.51), process subscale, 12 items ( α = 0.62), and service quality (outcome) also consisted of 12 items ( α = 0.58). Mardia’s Skewness and Kurtosis, Henze–Zirkler, and Doornik–Hansen multivariate normality tests were conducted at p values of .006, .102, .034, and .048, respectively, to ensure the independence of each construct as well as to satisfy the normality criteria. Descriptive analysis was also run to determine the extent to which the items reflect the current state of healthcare delivery. Finally, correlation, linear regression, and multivariate analysis of variance (MANOVA) analyses were carried out at a significant level of ≤0.05 to determine relationships and effects on healthcare delivery outcomes. Results Findings indicated a generally neutral opinion of the quality measures in relation to structures, processes, and outcomes of care at the study facility. Nurses faced limitations in providing needed care due to inadequate policy framework and enforcement, insufficient human resources, and lack of motivational packages. A Pearson r correlation matrix of the Donabedian constructs showed significant positive relationships between Structure and Process as well as Outcome and Process categories. A weak positive association outcome and structure constructs was, however, deemed insignificant. A MANOVA determined a significant effect of respondents’ gender and educational levels on their perception of quality healthcare. Conclusion Supervision in the hospital company and staff-management relationship must be strengthened to ensure a holistic quality of nursing care delivery.

Enhancing patient satisfaction in COVID-19 wards: a randomized controlled trial on the impact of supportive educational programs in Najaf hospitals

2025-06-18

Dhuha Ahmed Al-Qaseer , Mohammad Namazinia , Fatemeh Hajiabadi +2 more | Frontiers in Psychiatry

Background The COVID-19 pandemic has severely impacted global health, pervasively affecting the physical and mental wellbeing of individuals worldwide. As the pandemic continues, evaluating patient satisfaction within healthcare has become … Background The COVID-19 pandemic has severely impacted global health, pervasively affecting the physical and mental wellbeing of individuals worldwide. As the pandemic continues, evaluating patient satisfaction within healthcare has become increasingly critical. This study examines the impact of supportive educational programs on patient satisfaction in COVID-19 wards in Najaf hospitals. Method A randomized clinical trial involving 60 patients admitted to COVID-19 departments was conducted. The intervention group received a comprehensive supportive educational program upon hospital admission, while the control group received standard care. Participant satisfaction levels were measured using a translated and adapted version of Wolf’s Patient Satisfaction Instrument. Analysis was performed on demographic data and satisfaction scores through descriptive statistics and inferential tests using SPSS version 21. Results The study revealed that the intervention group reported significantly higher satisfaction scores compared to the control group across all measured domains, including professional-technical care, trust, and patient education. These results suggest that supportive educational programs can significantly enhance patient satisfaction during hospitalization for COVID-19. Conclusion Supportive educational interventions are effective in improving patient satisfaction, which is an important metric for healthcare quality. This study indicates that supplementing standard care with educational and emotional support benefits patients, pointing toward the need for integrated care approaches that address both physical and psychological needs during pandemics. Future research could focus on long-term impacts and explore the potential for virtual implementation of similar programs. Clinical trial registration https://irct.behdasht.gov.ir/trial/58407 , identifier IRCT20140625018231N1.

Navigating the patient experience in primary healthcare clinics in the eastern province of Saudi Arabia: a secondary analysis study

2025-06-17

Mishael Alhuseini , Duaa Aljabri , Arwa Althumairi +1 more | Frontiers in Medicine

Background The patient experience is a critical indicator of healthcare quality, particularly in primary healthcare centers (PHCCs). Understanding patients’ perceptions is essential for improving service delivery and achieving patient-centered care. … Background The patient experience is a critical indicator of healthcare quality, particularly in primary healthcare centers (PHCCs). Understanding patients’ perceptions is essential for improving service delivery and achieving patient-centered care. Despite healthcare reforms in Saudi Arabia, research on patient experiences in PHCCs in the Eastern Province remains limited. Objective This study aims to analyze patient experience trends in PHCCs within the Eastern Health Cluster of Saudi Arabia, identifying factors influencing satisfaction levels. Methods A secondary analysis was conducted using patient experience data from the Ministry of Health’s Press Ganey survey. Data from 81,211 completed surveys collected between 2022 and 2023 were analyzed. The survey assessed seven domains of patient experience, and statistical tests, including t -tests and one-way ANOVA, were used to examine variations by demographic factors. Results The overall patient experience score was 85.4%, with the highest satisfaction in the registration process (88.6%) and the lowest in the “moving through” domain (79%). Elderly patients (&gt;65 years) reported higher satisfaction compared to younger adults (18–34 years) ( p &lt; 0.05). Male patients expressed slightly greater satisfaction than females ( p &lt; 0.05). Satisfaction varied across health networks, with Network C receiving the highest scores (88.8%) and Network B the lowest (83.2%). Patient satisfaction improved from 2022 (84%) to 2023 (86.4%). Conclusion The patient experience in PHCCs within the Eastern Health Cluster has improved over time, reflecting ongoing healthcare reforms. However, disparities exist across demographic groups and health networks. Addressing patients’ concerns about wait times and service flows is necessary to enhance satisfaction. Future research should explore qualitative aspects of the patient experience and assess interventions to improve healthcare accessibility and equity.

Assessing Patient Demographics Associated with Telehealth and In-Person Contraceptive Care at a Tertiary Care Institution

2025-06-17

Amanda S. Farrell , Anna Roselle , Elysia Larson +2 more | Journal of Women s Health

Objective: To describe the patient population accessing in-person versus telehealth contraceptive care and to identify demographic disparities in telehealth care utilization. Design: We conducted a retrospective chart review of patients … Objective: To describe the patient population accessing in-person versus telehealth contraceptive care and to identify demographic disparities in telehealth care utilization. Design: We conducted a retrospective chart review of patients accessing telehealth and in-person contraceptive care at an academic health center between January 1, 2021, and December 31, 2021. Billing data were used to identify medical records for patients aged 18-54 who had a contraceptive visit during this time. Demographic and past medical history were collected from the electronic health record. Results: A total of 1,435 unique patients were included. Of 1,691 total visits, 16% were telehealth visits. Being publicly insured was significantly associated with decreased likelihood of having a telehealth visit compared with an in-person visit and remained so after adjusting for race, marital status, and language (adjusted risk ratio [aRR]: 0.51, confidence interval [CI]: 0.33-0.78). Individuals aged 45 years and older were less likely to have telehealth visits (aRR: 0.52, CI: 0.27-1.02). Being single was positively associated with accessing telehealth contraceptive care (aRR: 1.57, CI: 1.06-2.23). There were no statistically significant associations by race or ethnicity. Intrauterine devices were the most commonly prescribed contraceptive type after an in-person visit (35%) while oral contraceptives were the most commonly prescribed after telehealth visits (37%). Conclusions: Our study found decreased utilization of telehealth for contraceptive care among patients who are publicly insured and older than 45. We found no differences in the use of telehealth for contraceptive care by race, ethnicity, or language. Telehealth is a powerful tool with the potential to increase equity in health care. It is important to continue research to understand how patient demographics affect use of telehealth for contraceptive care to facilitate more equitable access.

Translation and Validation of the Thai Version of the Quality Nursing Care Questionnaire (T-QNCQ)

2025-06-17

Vachira Posai , Armarapas Atthachaiwat , Teeraporn Sathira-Angkura +6 more | Journal of Health Science and Medical Research

Objective: The Quality Nursing Care Questionnaire (QNCQ) has been widely used to assess nurses’ perceptions of care quality. However, there was a lack of studies validating the QNCQ in Thai … Objective: The Quality Nursing Care Questionnaire (QNCQ) has been widely used to assess nurses’ perceptions of care quality. However, there was a lack of studies validating the QNCQ in Thai healthcare settings, highlighting the need for its adaptation. This study aimed to translate the QNCQ into Thai and evaluate its internal consistency and psychometric properties. Materials and Methods: A cross-sectional study design was used in this research. The Thai version (T-QNCQ) was a self-reported questionnaire consisting of 38 items across 5 response categories, covering 6 dimensions: physical environment, staff characteristics, preconditions, task-oriented activities, human-oriented activities, and patient outcomes. A sample of 380 registered nurses from tertiary government hospitals in Thailand was recruited using purposive and convenience sampling. To assess the validity of the translated scale, confirmatory factor analysis (CFA), descriptive statistics, and reliability testing were conducted. Results: The T-QNCQ demonstrated strong reliability and validity. The Cronbach’s alpha coefficient for the total scale was 0.98, with subscale values ranging from 0.86 to 0.94. Item-total correlations for the overall scale were positive, ranging from 0.61 to 0.84. Construct validity was supported by CFA, which yielded the following fit indices: comparative fit index=0.95, Tucker-Lewis index=0.94, root mean square error of approximation=0.05, and standardized root mean square residual=0.04. Conclusion: The T-QNCQ was found to be a reliable and valid tool for assessing nurses’ perceptions of care quality in Thai healthcare settings. These results provide valuable insights for nurse administrators and policymakers, aiding improvements in care delivery.

The Association Between Physician Demographics on Patient Satisfaction Survey Results in Pediatrics: A Role for Implicit Bias?

2025-06-16

David J. Sas , Imad Absah , Sean M. Phelan +5 more | Clinical Pediatrics

We assessed associations of pediatrician demographic characteristics with patient satisfaction (PS) scores. We performed a retrospective analysis of PS scores among pediatricians at a single academic institution and their associations … We assessed associations of pediatrician demographic characteristics with patient satisfaction (PS) scores. We performed a retrospective analysis of PS scores among pediatricians at a single academic institution and their associations with individual demographic features including gender, race, and geographic location of medical school education. We analyzed PS survey results for 153 pediatricians, 48.4% of whom were female. Males received higher scores in 4 out of 10 questions including “Likelihood of your recommending this care provider to others” ( P = .007). We observed similar findings for white pediatricians compared to Black, Indigenous, and People of Color (BIPOC) ( P = .033) and US medical school graduates compared to international school graduates ( P = .044). Overall, we observed that pediatricians who are female, BIPOC, or international medical school graduates receive lower PS scores than their counterparts. The impact of potential survey responder bias should be acknowledged when interpreting PS scores for pediatricians.

Qualitative exploration of chronic kidney disease patients’ attitudes, perceptions and satisfaction on medical care via video conferencing in Bangladesh

2025-06-16

Mohammad Zahedul Alam , Erina Khan Elin | International Journal of Pharmaceutical and Healthcare Marketing

Purpose Video conferencing has become a widely used method for providing medical care and conducting routine checkups. In Bangladesh, the Kidney Foundation Hospital and Research Institute has embraced the use … Purpose Video conferencing has become a widely used method for providing medical care and conducting routine checkups. In Bangladesh, the Kidney Foundation Hospital and Research Institute has embraced the use of video conferencing to administer treatment of chronic kidney diseases since the onset of the COVID-19 pandemic, and this approach continues to be implemented to this day. The purpose of this study is to explore the perceptions, attitudes and satisfaction of kidney disease patients regarding video conferencing consultations. Design/methodology/approach This is a qualitative exploration of the perceptions, attitudes and satisfaction of patients with video conferencing in the context of chronic kidney disease. Kidney Foundation Hospital and Research Institute, one of the leading kidney disease research institutes, has been selected for this study. Semi-structured, one-to-one interviews were conducted with ten patients receiving medical care through video conferencing using open-ended questions. Findings The patients trusted the physician and were satisfied with their video consultation experience, with the majority believing that they were being correctly evaluated through video conferencing. They reported that video consultation was convenient, safe, secure, less costly and time-saving for them. Few of the patients expressed apprehensions regarding incorrect treatment. However, most of the patients were satisfied, had a positive attitude toward video conferencing for their medical care and intended to continue using video conferencing for this purpose in the future. Practical implications The insights obtained from this study can be effectively used by health-care providers, top managers of e-health organizations, policymakers and hospital administrators. Originality/value This study provides insights into understanding the perceptions, attitudes, opinions and satisfaction with video conferencing platform by chronic kidney patients. Only a limited number of qualitative studies were conducted for medical care via video conferencing with chronic kidney diseases in the context of Bangladesh.

Impact of Telehealth on Pediatric Direct Primary Care: Is Virtually Showing Up Valuable?

2025-06-16

Austin Lee , Nicholas G Belt , Keili Mistovich +2 more | Cureus

Audit of patients attending the pain clinic of Shaheed Suhrawardy Medical College Hospital in Bangladesh during the period 2022-2023

2025-06-15

Md Mostafa Kamal , Wani M. Amin , Md Kamruzzaman Bhuiyan +4 more | Journal of Shaheed Suhrawardy Medical College

Background: Pain is an unavoidable part of life. More than 1.5 billion people worldwide live with chronic pain and the prevalence rate is about 11.6%. Pain clinics are healthcare facilities … Background: Pain is an unavoidable part of life. More than 1.5 billion people worldwide live with chronic pain and the prevalence rate is about 11.6%. Pain clinics are healthcare facilities that provide standard services to help people manage their pain and regain control of their lives. The objective of this study was to analyze the chronic pain patients of the pain clinic of Shaheed Suhrawardy Medical College Hospital between 2022 and 2023. Methods: This was a retrospective observational study conducted in the pain clinic of Shaheed Suhrawardy Medical College Hospital, Dhaka, Bangladesh. Patients with persistent pain for more than 3 months attending the pain clinic between 1 January 2022 and 31 December 2023 were included. Sociodemographic variables, pain characteristics, pain intensity at the first visit, pain duration, and treatments were extracted from the records. Results: After reviewing the clinical records, 934 patients were selected for this study. The mean age of the patients was 41.62 ± 10.87 years. The persistent pain duration was 10.52 ± 2.25 months and 542 (58%) experienced moderate pain measured by visual analogue scale (VAS). Most of the patients suffered from chronic musculoskeletal pain 456 (49%) followed by chronic neuropathic pain 196 (21%) and chronic post-traumatic pain 159 (17%). A large proportion complained of localized pain 719 (77%) and the lower back was the most prevalent site 446 (48%). A great number of patients 662 (71%) were treated conservatively rather than interventions 272 (29%) to manage their pain. The most common type of intervention was epidural injection (30%) followed by intra-articular injection (21%) and nerve blocks (15%). Conclusion: This research sheds light on the role of pain clinics in crafting tailored pain management strategies. This study's findings give insight into chronic pain patients and pain management practices who attended the pain clinic. J Shaheed Suhrawardy Med Coll 2023; 15(2): 6-11

Multivariate analysis of the effect of health literacy levels on patient satisfaction in patients presenting to the emergency department

2025-06-13

Oya Akpınar Oruç , Ridvan Sener | Medicine

In this research, it was aimed to evaluate the effect of health literacy levels on patient satisfaction in patients presenting to the emergency department at a multivariate level. A total … In this research, it was aimed to evaluate the effect of health literacy levels on patient satisfaction in patients presenting to the emergency department at a multivariate level. A total of 404 patients who applied to the Emergency Medicine Unit of Afyonkarahisar Health Sciences University were subjected to the survey. A survey including a demographic information form, Health Literacy Scale and Emergency Patient Satisfaction Scale was applied as a data collection tool in the study. The general health literacy mean was 50.17 ± 10.73 with a 14.0 to 70.00 range, and the emergency service patient satisfaction level was 73.20 ± 19.64 with an 18.00 to 90.00 range. Total health literacy was positively and significantly correlated with nurse satisfaction ( R = 0.221; P < .01), admission staff satisfaction ( R = 0.324; P < .01), emergency service environment satisfaction ( R = 0.127; P < .05), physician care satisfaction ( R = 0.276; P < .01), general patient satisfaction ( R = 0.256; P < .01), and total emergency service patient satisfaction ( R = 0.227; P < .01). The effect of critical health literacy had significant effect on nurse satisfaction (odds ratio [OR], 0.209; P < .01). Effects of interactive health literacy (OR, 0.064; P < .05) and critical health literacy (OR, 0.121; P < .05) on admission staff satisfaction were significant. The effect of interactive health literacy on the emergency service environment was statistically significant (OR, 0.153; P < .01). Effect of critical health literacy on physician care was significant (OR, 0.254; P < .01). Effects of interactive health literacy (OR, 0.173; P < .05) and critical health literacy (OR, 0.227; P < .05) on general patient satisfaction were significant. Patient satisfaction in emergency services varies not only with internal or environmental factors but also with respect to patients’ perceptions. Patients’ trust and satisfaction in the health system also positively affect the treatment process and participation in the health system.

1120-P: Use of Choice Architecture to Influence Inpatient A1C Ordering and Patient Outcomes

2025-06-13

Kristen Breslin , Arnold J. Marx , Sam Sokolinsky +7 more | Diabetes

Introduction and Objective: ADA guidelines state that inpatients with diabetes mellitus (DM) or hyperglycemia should have an A1c tested if none are available from the past 3 months. Unfortunately adherence … Introduction and Objective: ADA guidelines state that inpatients with diabetes mellitus (DM) or hyperglycemia should have an A1c tested if none are available from the past 3 months. Unfortunately adherence to this recommendation is often poor. The purpose of this study was to evaluate whether utilization of choice architecture, a tenet of behavioral psychology, in the EMR could influence inpatient A1c testing rates. Furthermore, we sought to investigate whether changes in A1c testing rates would be associated with patient outcomes or DM medication prescribing practices on discharge. Methods: The A1c order in the EMR insulin order set at 3 community hospitals in the same health system was changed from default unselected (“opt-in”) to pre-selected (“opt-out”). Using a retrospective cohort study design, we evaluated adult DM inpatients (age≥18y) from 1/1/21 - 2/28/23, comparing the pre-intervention vs post-intervention time periods. Only patients’ initial hospitalizations were included for analyses. Chi-square, Mann-Whitney U, or multivariate logistic regression tests were used to compare between groups. Results: A total of 5847 patients were evaluated pre-intervention and 5598 patients post-intervention. Patient characteristics were similar between groups. Rates of A1c testing increased significantly after intervention (64.7% vs 78.8%; p&lt;0.001). This was associated with a significant decrease in 30-day readmission rates (30DRR; 12.4% to 11.1%; p=0.046). No changes were seen for rates of endocrine consultation, hospital length of stay or mortality. On discharge, rates of insulin prescriptions significantly decreased post-intervention, whereas rates of SGLT2i and GLP-1RA significantly increased (p’s&lt;0.001). Conclusion: A strategy of opt-out, rather than opt-in, A1c ordering was associated with significantly increased rates of inpatient A1c testing, decreased 30DRR and increased non-insulin DM medications on discharge. Further studies are warranted to confirm these findings. Disclosure K. Breslin: None. A. Marx: None. S. Sokolinsky: None. L. Burometto: None. E.H. Gonzales: None. M. Motevalli: None. H. Bashura: None. C. Stanback: None. M. Zilbermint: Consultant; Dexcom, Inc. A. Demidowich: None.

Time is now to consider how we evaluate person-centred care—the role of patient-reported outcomes

2025-06-13

Claudia Rutherford , Jan R. Boehnke , Joanne Greenhalgh +3 more | Frontiers in Health Services

Person-centred care refers to health care that is respectful of and responsive to personal experiences, preferences, needs, goals and values of service users. Despite the growing recognition of the value … Person-centred care refers to health care that is respectful of and responsive to personal experiences, preferences, needs, goals and values of service users. Despite the growing recognition of the value of patient-reported outcome measures, they are rarely used as evaluation endpoints in person-centred care research and care practices. This paper contributes to knowledge by examining the opportunities and challenges of using patient-reported outcome measures to measure person-centred care. Our focus is not the collection and feedback of patient-reported outcomes to enact person-centred care. We discuss differences between patient- and person-reported outcomes and their role in assessing person-centred care. We also challenge some existing measurement practices and usage of existing patient-reported outcome measures. We critically discuss some potential consequences of current practices, and present possible solutions. We do not have all the answers, and we urge those working in the field of patient-reported measurement to collectively come together to find solutions. With this perspective article, we aim to start the conversation to think differently about how we evaluate person-centred care and propose areas of enquiry that incorporate patient-reported outcomes into the evaluation of person-centred care.

The Impact of Primary Disease on Patient Satisfaction in Outpatient Care: A Nationwide Analysis

2025-06-13

Jinhee Park , Jinhyun Kim | Journal for Healthcare Quality

ABSTRACT Background: Patient satisfaction is a key indicator of health care quality, yet the impact of primary diseases on outpatient satisfaction remains underexplored. This study examined whether the primary disease … ABSTRACT Background: Patient satisfaction is a key indicator of health care quality, yet the impact of primary diseases on outpatient satisfaction remains underexplored. This study examined whether the primary disease independently influences patient satisfaction. Methods: We retrospectively analyzed 8,259 outpatient experience records from clinics (n = 6,347), hospitals (n = 1,374), and tertiary hospitals (n = 538) using data from the 2023 Medical Service Experience Survey in Korea. The primary diseases for outpatient visit were categorized into 50 specific conditions grouped under 9 disease categories. Multivariate analyses were conducted, adjusting for demographic and health care-related factors. Results: The primary disease was identified as an independent factor affecting satisfaction. Patients with cancer, particularly those with thyroid and breast cancer, reported the highest satisfaction, whereas patients with depression or bipolar disorder had the lowest. In addition, different diseases independently influenced satisfaction to varying degrees. Factors such as medical provider's manner (especially nurses) and facility convenience were also significantly associated with satisfaction. Conclusions: Although the precise mechanisms remain unclear, the primary disease should be considered an important determinant of patient satisfaction. Future research should take into account the impact of specific diseases on patient satisfaction when designing studies or interpreting results.

Nurses’ Engagement in Antimicrobial Stewardship Programmes: A Mapping Review of Influencing Factors Based on Irvine’s Theory

2025-06-12

Susana Filipe , Paulo Santos‐Costa , Celeste Bastos +1 more | Nursing Reports

Antimicrobial resistance (AMR) is a pressing global health challenge, driving the need for effective antimicrobial stewardship (AMS) programmes. Despite nurses’ critical role in care delivery, their involvement in AMS remains … Antimicrobial resistance (AMR) is a pressing global health challenge, driving the need for effective antimicrobial stewardship (AMS) programmes. Despite nurses’ critical role in care delivery, their involvement in AMS remains under-recognized. Objectives: This mapping review aims to identify barriers and facilitators influencing nurses’ engagement in AMS programmes and examine nursing-sensitive outcomes associated with their participation, using Irvine’s Nursing Role Effectiveness Model (NREM) as a guiding framework. Methods: A systematic mapping review was conducted following Joanna Briggs Institute (JBI) guidance and reported using the PRISMA-ScR checklist. The protocol was registered on the Open Science Framework. Searches were conducted in MEDLINE, CI-NAHL, Scopus, LILACS, Scielo, and grey literature sources. Data were extracted and categorized according to the NREM domains: structure, process, and outcomes. Results: Thirty-two studies were included. Key barriers included limited AMS knowledge, role ambiguity, hierarchical dynamics, communication gaps, and lack of standardized nursing outcomes. Facilitators encompassed targeted AMS education, participation in multidisciplinary discussions, managerial support, and defined nursing roles. Nurse-led interventions showed potential to improve infection control and antibiotic administration, although standardized outcome reporting remains scarce. Conclusions: Framed by the NREM, this review underscores the essential contribution of nurses to AMS. Addressing structural barriers, enhancing role clarity, and fostering interdisciplinary collaboration are critical to enabling nurses’ full participation. Strengthening nursing engagement in AMS not only supports effective antimicrobial use and patient safety but also reinforces health system resilience and sustainability.

Patient experiences of WALANT for outpatient upper limb surgery: A cross-sectional study of perioperative pain and anxiety

2025-06-12

Reshlan Govender , Antoine Rocher , Marc Rankin +3 more | Journal of the Colleges of Medicine of South Africa

Background: Demands on South African operating theatres have led to more outpatient upper limb surgery being performed under wide awake local anaesthesia no tourniquet (WALANT). This study aimed to determine … Background: Demands on South African operating theatres have led to more outpatient upper limb surgery being performed under wide awake local anaesthesia no tourniquet (WALANT). This study aimed to determine patients’ anxiety and pain related to WALANT use in outpatient upper limb surgery, and to identify factors that increased the risk of heightened pain experiences. Methods: This multicentre cross-sectional study conducted between December 2022 and June 2024 utilised the ‘strengthening the reporting of observational studies in epidemiology guidelines’. Patients receiving outpatient upper limb surgery under WALANT were prospectively recruited for participation in an investigator-administered questionnaire of 15 questions regarding their demographics, procedure, anxiety and pain experiences. Patients’ anxiety and pain experiences were summarised, and relationships between demographic or procedural factors and anxiety or pain scores were tested. Results: In all, 85 patients were included. The most frequent procedures performed were tendon repairs and trigger releases (42% and 12% respectively). Of the total recruited patients, 45% reported moderate to severe anxiety perioperatively. The median visual analogue scale (VAS) score for pain of injection and procedure were 20 mm and 0 mm, respectively. Male patients and isiZulu speaking patients had lower VAS pain scores, while very anxious patients had higher VAS pain scores. Conclusion: Forty-five per cent of patients who underwent outpatient upper limb surgery under WALANT experienced perioperative anxiety. They did not experience the anaesthetic or surgery as painful on average. Pain scores were related to perioperative anxiety. Future investigation should further explore the relationship between perioperative anxiety and pain. Contribution: Wide awake local anaesthesia no tourniquet is well tolerated in patients undergoing outpatient upper limb surgery.

A Cross-Sectional Client Satisfaction Study Among Persons Living with HIV Attending a Large HIV Treatment Centre in Trinidad

2025-06-12

Jonathan Edwards , Sharon Soyer , Noreen Jack +4 more | Healthcare

Background: Client satisfaction with HIV service delivery reflects the ability of healthcare providers to effectively deliver care and treatment that meets the requirements and expectations of clients, and is associated … Background: Client satisfaction with HIV service delivery reflects the ability of healthcare providers to effectively deliver care and treatment that meets the requirements and expectations of clients, and is associated with improved health outcomes, including increased retention in care and HIV viral suppression. The aim of the study was to conduct a client satisfaction study among PLHIV attending a large HIV clinic in Trinidad to identify the gaps in service delivery and factors associated with reduced HIV viral suppression. Methods: This cross-sectional study was conducted over the period April 2023–March 2024 among 362 clients attending the HIV clinic. A structured, pre-tested questionnaire collected demographic data and factors that affected client clinic experiences, including wait time, communication with staff, confidentiality, physical amenities and HIV viral suppression. Multivariable logistic regression was used to assess the likelihood of reporting satisfaction based on key independent variables. Results: Among participants, 219 (60.5%) were females, 202 (55.8%) were aged 30–49 years and 337 (93.1%) were virally suppressed. Participants reported satisfaction with overall care (95.3%), confidentiality (95.9%) and interactions with doctors (96.1%), nurses (98.6%) and other staff. Dissatisfaction was reported with facility-related, elements including the outdoor/tented waiting area (46.1%), the toilet/washrooms (37.0%) and the clinic wait time (31.8%). Participants were less likely to be satisfied with the amount of medication received if they had unsuppressed viral loads (p = 0.035), were aged 20–29 years old (p = 0.048) or had a tertiary education (p = 0.008). Conclusions: The study showed that 93.1% of the study participants were virally suppressed, and there was a general level of satisfaction with the overall care at the clinic, confidentiality and healthcare workers’ service delivery; however, gaps involving the physical facilities, wait times and medication services should be prioritized.

Global Communication Practices and Their Impact on Patient Caregivers’ Satisfaction in the Surgical Waiting Area: A Scoping Review

2025-06-12

Dnyata Dhanajirao Pandit , Sai Bhavana , Anitha Nileshwar +5 more | Healthcare

Background/Objectives: Effective communication between healthcare professionals and patient caregivers is paramount in the surgical waiting area, particularly during periods of heightened stress and emotional vulnerability. Globally, communication practices exhibit considerable … Background/Objectives: Effective communication between healthcare professionals and patient caregivers is paramount in the surgical waiting area, particularly during periods of heightened stress and emotional vulnerability. Globally, communication practices exhibit considerable variability, from traditional face-to-face interactions to integrating advanced digital technologies. Despite innovations, a comprehensive understanding of the impact of diverse communication strategies on patient caregiver satisfaction remains underdeveloped. This scoping review was designed to systematically map the existing literature on healthcare communication practices and identify strategies that may influence satisfaction among patient caregivers. Methods: A thorough search of multiple databases—Scopus, PubMed, CINAHL, Embase, ProQuest, Web of Science, the Cochrane Library, and clinical trial registries—was conducted. Only studies published in English or those for which an English full text was accessible were included. Eligible studies were those undertaken in hospital settings, including operating theaters, surgical units, surgical waiting areas, postoperative intensive care units, emergency departments, and other clinical areas focusing on patient caregivers. The review adhered to the methodological framework recommended by the Joanna Briggs Institute for scoping reviews and was reported following the most recent PRISMA-ScR guidelines. Results: Ultimately, five studies met the inclusion criteria. The selection process involved a structured search utilizing Medical Subject Headings (MeSH), keywords, and index terms, supplemented by manual reference list screening. Initial screening was performed based on titles and abstracts, followed by full-text evaluation using a standardized selection form. Data extraction focused on the communication methods, study designs, and outcomes related to patient caregiver satisfaction. The findings are synthesized narratively and presented through tables and figures, offering a comprehensive overview of global communication practices and their influence on patient caregiver satisfaction in surgical environments. Across the five included studies, digital communication interventions such as SMS, mobile apps, or video updates reported improved patient caregiver satisfaction (e.g., 70.8% in Canada and 97% in Switzerland) and also reduced patient caregiver anxiety (e.g., STAI score ≥ 44) in 74.2% of Ethiopian patient caregivers. Worldwide evidence highlights the practical importance of tailored digital communication practices to support providing timely and accessible information to patient caregivers, while also revealing gaps linked to insurance status, digital literacy, and various communication approaches in healthcare systems. Conclusions: The five studies included showed considerable variation in communication practices across surgical settings. The main findings reveal that structured, timely, and transparent communication, mainly via digital tools such as SMS updates and mobile applications, enhanced patient caregiver satisfaction and alleviated their emotional distress too. Nevertheless, gaps were identified in postoperative communication, and challenges, such as technological accessibility, digital literacy skills of patient caregivers, and inconsistent methods for measuring satisfaction outcomes, were noted across studies. This scoping review identified the different types of healthcare communication practices adopted globally in surgical care settings and also demonstrated their influence on patient caregiver satisfaction. Traditional and digital communication practices both have their significant impact on patient caregiver experiences in surgical healthcare settings, focusing more on timely and consistent real-time updates and culturally sensitive information. Addressing the existing communication gaps and having tailored communication approaches to specific contexts may lead to improved patient caregiver support and surgical outcomes.

Research on the impact of hospital organizational behavior on physicians'patient-centered care

2025-06-11

Pengwei Zhang , Haotong Zhang , Anqi Wang | Archives of Public Health

Mapping of disclosure practices in hospital settings: scoping reviewMapeamento das práticas de disclosure em ambientes hospitalares: revisão de escopo

2025-06-10

Giselle Viana Miralhes Vargas , Raphael Dias de Mello Pereira , Davi da Silveira Barroso Alves | Revista de Pesquisa Cuidado é Fundamental Online

Objetivo: mapear as práticas de disclosure de eventos adversos para pacientes internados e seus acompanhantes, relacionadas à segurança do paciente, em ambientes hospitalares. Método: trata-se de uma pesquisa qualitativa, do … Objetivo: mapear as práticas de disclosure de eventos adversos para pacientes internados e seus acompanhantes, relacionadas à segurança do paciente, em ambientes hospitalares. Método: trata-se de uma pesquisa qualitativa, do tipo revisão de escopo, desenvolvida a partir da metodologia aplicada pelo Joanna Briggs Institute para revisões de escopo. Resultados: foram identificados 3876 artigos nas bases citadas; e 180 publicações na literatura cinzenta. Após a exclusão dos estudos duplicados, validação dos critérios de inclusão e leitura na íntegra, foram eleitas 25 publicações científicas para a análise. Conclusão: a partir da revisão de escopo, observou-se diversas estratégias para executar a prática do disclosure, dentre elas, o pedido de desculpas surgiu como uma forma de reduzir o impacto dos eventos adversos, e demonstrar empatia, respeito e responsabilidade, por parte dos profissionais de saúde.

Patient perspectives in neurosurgery: the role of patient-reported experience measures (PREM) in enhancing care quality

2025-06-07

Marie Bertl , Jana Schleitzer , Marcel A. Kamp +5 more | Neurosurgical Review

Validation and psychometric testing of the care-related regret intensity scale among clinical nurses: a methodological study

2025-06-06

Mobina Jamshidinia , Alireza Mirzaei , Reza Nemati‐Vakilabad | BMC Nursing

The experience of care-related regret among clinical nurses, often stemming from high workloads and the need for quick decision-making, can significantly impact job satisfaction and performance. Recognizing the necessity of … The experience of care-related regret among clinical nurses, often stemming from high workloads and the need for quick decision-making, can significantly impact job satisfaction and performance. Recognizing the necessity of measuring this regret, our research aimed to translate and evaluate the psychometric properties of the Care-related Regret Intensity Scale (RIS-10) among Iranian clinical nurses. In this methodological study with a cross-sectional design, a sample of 400 clinical nurses was selected using convenience sampling. The Care-related Regret Intensity Scale (RIS-10) was translated into Persian using a forward-backward translation procedure. This translated version was subsequently utilized for psychometric evaluation, which included an assessment of face validity, content validity, and construct validity through Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA). Furthermore, internal consistency and stability reliability were assessed. The RIS-10 maintained the meaning of the original English version and was clear, explicit, and understandable for clinical nurses. The content validity was evaluated using CVR and CVI indices, revealing that all items had a CVR above 0.62 and a CVI exceeding 0.79. EFA identified a single latent factor explaining 68.48% of the total variance. The subsequent CFA demonstrated that all items achieved a factor loading of at least 0.3, with goodness-of-fit statistics supporting an excellent fit for the final RIS-10 model. The values of Cronbach's alpha coefficient and McDonald's omega were 0.924 and 0.921 for the overall scale, respectively. Additionally, the stability was ICC = 0.913 (95% CI, 0.863-0.941). The Persian version of the Care-Related Regret Intensity Scale (RIS-10) is valid and reliable, confirming its suitability for use. It effectively measures the intensity of care-related regret among clinical nurses in Iran. Not applicable.