Factors Affecting Patient Satisfaction Research Articles

Rheumatoid Arthritis Patients Achieve Better Satisfaction but Lower Functional Activities as Compared to Osteoarthritis Patients After Total Knee Arthroplasty

BackgroundRecently, poor patient satisfaction after total knee arthroplasty (TKA) has gained attention mainly in osteoarthritis (OA) patients; however, satisfaction after TKA remains to be understood in rheumatoid arthritis (RA) patients. This study aimed to examine satisfaction and function after RA TKA using patient-reported outcome measures and to compare the results with those of OA-TKA. MethodsThis study enrolled 534 TKAs of 501 patients consisting of 75 TKAs of 70 RA patients and 459 TKAs of 431 OA patients. Data of patient-reported outcome measures such as new Knee Society Score 2011, Pain Catastrophizing Scale, and Pain DETECT Score were collected at 2 years. Multiple regression analysis was performed with Knee Society Score satisfaction score set as a dependent variable in order to clarify factors affecting patient satisfaction. Principle component analysis was performed, and satisfaction and function components were compared between RA and OA. ResultsAll activity scores were significantly lower in RA TKA than in OA TKA, whereas the range of motion and patient satisfaction scores were significantly better in RA TKA than in OA TKA. Scores for symptom, expectation, basic activity, and discretional activity positively affected patient satisfaction (P < .001), while Pain Catastrophizing Scale negatively did (P = .021). Importantly, diagnosis of RA itself pushed up the patient satisfaction score by 1.5 points. Principle component analysis revealed that RA TKA achieved significantly higher satisfaction component (P = .001), but lower function component (P < .0001) compared to OA TKA. ConclusionPatient satisfaction was better but functional activity was lower in RA than in OA. As poor functional activity was evident preoperatively in RA patients, to improve functional outcome should be future challenge for RA TKA.

Uncorrected visual acuity, postoperative astigmatism, and dry eye symptoms are major determinants of patient satisfaction: a comparative, real-life study of femtosecond laser in situ keratomileusis and small incision lenticule extraction for myopia.

PurposeTo compare factors affecting patient satisfaction after femtosecond laser in situ keratomileusis (FS-LASIK) and small incision lenticule extraction (SMILE) for myopia in the real-life situation study.MethodsThe SMILE group included 100 eyes (51 patients) and the FS-LASIK group 200 eyes (102 patients). In addition to clinical examination, dry eye symptoms and patient satisfaction with far and near vision were reported and graded on the visual analog scale preoperatively and one month after the operation. Case–control pairs were selected for the SMILE patients from FS-LASIK-treated patients to ensure the homogeneity in spherical equivalent refraction, preoperative dry eye, and visual satisfaction.ResultsEighty percent of SMILE eyes and 83% of FS-LASIK eyes achieved an uncorrected distance visual acuity of 20/20 or better. Predictability (±0.5 D of mean target spherical equivalent refraction) was 91% in SMILE and 93.5% in FS-LASIK. No eyes lost two or more Snellen lines of corrected distance visual acuity. Based on case–control pairs, dry eye symptoms remained the same after one month in the FS-LASIK-treated eyes (P=0.87) but decreased in the SMILE-treated eyes (P=0.01) compared with the preoperative situation. Patient satisfaction with far vision improved significantly in both groups (P<0.001), but satisfaction with near vision improved significantly only in FS-LASIK (P<0.001) and not in SMILE (P=0.58). There was more postoperative astigmatism in SMILE in comparison with FS-LASIK (P=0.002).ConclusionsIn a real-life situation, patients with preoperative dry eye experience were often directed to the SMILE operation, which resulted in beneficial decrease in their dry eye symptoms. Patient satisfaction with far vision decreased with increasing dry eye symptoms and postoperative astigmatism in both SMILE- and FS-LASIK-treated emmetropic patients. Safety, efficacy, and predictability were comparable in both treatments.

Impact of Macroeconomic and Healthcare Provision Factors on Patient Satisfaction

This article examines how macroeconomic and healthcare provision factors affect patient satisfaction. In line with the specialized literature, we have formulated two hypothesis statements that were tested on a sample of 31 countries, using 2012, 2013 and 2014 data. OLS regression models were used for testing different explanatory variables and their impact on patient satisfaction. The main findings of the study clearly illustrate a positive and strong relationship between patient satisfaction and healthcare provision, namely practising physicians and the number of nurses, and macro-economic factors such as public healthcare expenditure and GDP per capita. Furthermore, we notice a negative but strong correlation with healthcare infrastructure (available hospital beds) and private healthcare expenditure.

The Analysis of Factors Affecting Patient Satisfaction on Oral and Dental Health Service in Gusti Hasan Aman Oral and Dental Hospital of Kalimantan Selatan, Indonesia

The Analysis of Factors Affecting Patient Satisfaction on Oral and Dental Health Service in Gusti Hasan Aman Oral and Dental Hospital of Kalimantan Selatan, Indonesia

Factors affecting patient satisfaction with ecdemic medical care: a cross-sectional study in Nanchang, China.

PurposeThis study aimed to determine the factors that influence patient satisfaction with ecdemic medical care.Materials and methodsEight hundred and forty-four face-to-face interviews were conducted between October and November 2017 in two high-profile hospitals in Nanchang, China. Patient satisfaction was divided into lowest and highest satisfaction groups according the 80/20 rule. Demographic factors associated with patient satisfaction were identified by logistic regression models.ResultsRespondents’ main reasons for choosing a non-local hospital were “high level of medical treatment” (581/844), “good reputation of the hospital” (533/844), and “advanced medical equipment” (417/844). The top three items that dissatisfied the ecdemic patients were “long time to wait for treatment” (553/844), “complicated formalities” (307/844), and “poor overall service attitude” (288/844). Fewer female patients (adjusted odds ratio [AOR] =1.47, 95% confidence interval [CI] =1.03–2.11), patients with a family per-capita monthly income (FPMI) between 3,001 and 5,000 CNY (AOR =1.40, 95% CI =1.01–2.17), inpatients (AOR =1.46, 95% CI =1.01–2.13), and more patients with an FPMI >7,000 CNY (AOR =0.43, 95% CI =0.20–0.92) were detected in the lowest satisfaction group. Fewer patients with an associate’s or bachelor’s degree (AOR =2.40, 95% CI =1.37–4.20) and patients with an FPMI >7,000 CNY (AOR =3.02, 95% CI =1.10–8.33) were detected in the highest satisfaction group. Moreover, more inpatients (AOR =0.70, 95% CI =0.54–0.97) and those aged 46–65 years (AOR =0.63, 95% CI =0.33–0.98) were detected in the highest satisfaction group.ConclusionFindings suggested that managers of the medical facilities should note the importance of increasing their publicity through a rapidly developing media, as well as the necessity of creating a more patient-friendly medical care experience. Hospitals should also focus on the medical care experience of patients with relatively lower and higher income levels, male ecdemic patients, and ecdemic outpatients.

Evaluating factors affecting patient satisfaction using the Kano model

Healthcare providers are increasing their focus on patient satisfaction and patient-oriented services as they play a significant role in managing rising costs, elevating service quality and establishing sustainable quality improvement strategies. In recent years, the Kano model has gained popularity in the healthcare industry and has been employed to improve patient satisfaction. The purpose of this paper is to illustrate how the Kano model can be deployed to identify a wide range of complex patient needs and convey its potential usefulness in the continuous improvement of the healthcare sector. This paper provides a case study of implementing the Kano model to identify diverse patient needs and aims to eliminate the gaps identified in prior research, which include generically applying the Kano model to all service units of the healthcare system and using a predetermined service quality scale. This study emphasizes the importance of scale development and individual attention to each healthcare service unit in determining intricate patient needs. A cross-sectional study was conducted at the Student Health Services (SHS) of Missouri University of Science and Technology where the data were collected using the Kano survey. The respondents included undergraduate and graduate students that have utilized the healthcare services offered. A total of 138 patients were surveyed using a Kano model-based questionnaire that included demographics and treatment as well as service expectations. Of the 21 quality attributes evaluated by the patients, 16 were categorized as one-dimensional, 3 as indifferent, and 2 as attractive attributes using the Kano model. None of the quality attributes showed a dominant must-be feature. The students considered the availability of appropriately qualified medical staff within 10 minutes of the check-in process and provision of after-hours care as attractive attributes that create greater satisfaction. The research was conducted at a university SHS center. Therefore, respondents in the survey are in a younger age group, which may affect patient expectations. In addition, expectations of an SHS center may be different than expectations of visiting a primary care physician and other healthcare units. This study contributes to a better understanding of the identification of healthcare needs using the Kano model and advocates focusing on shifts in the categories over time and changes in the demographic environment.

Assessing patient satisfaction with the Medication Management Review service delivered in Jordan

Abstract Objective To investigate the effect of the Medication Management Review (MMR) service on the number of treatment-related problems (TRPs), patient satisfaction and factors affecting patient satisfaction. Methods This prospective, randomized controlled trial was conducted at community pharmacies in Amman, Jordan. Eligible patients were randomized into active and control groups. A validated Pharmaceutical Care Manual was used for data collection and to identify TRPs for both groups. Identified TRPs for patients in the active group were resolved at the pharmacist level or sent to the patients’ physicians for approval and implementation. Patients in both groups were followed up at 3 months to determine the number of TRPs end of the study. Patients in the active group completed a validated, Likert scale MMR-satisfaction questionnaire. Factors affecting satisfaction were assessed through multiple regression analysis. Key findings Outpatients with chronic conditions (n = 160) were recruited into the study, with mean age 53.01 ± 15.39; mean number of medical conditions of 3.56 ± 1.15 and 4.73 ± 1.79 mean number of medications. A mean number of 5.37 ± 3.01 TRPs per patient was identified, with no significant difference between both groups (active group n = 82, 5.57 ± 2.68; control n = 78, 5.18 ± 3.36, P = 0.412). At follow-up, significantly lower number of TRPs were identified for patients in the active group compared to patients in the control group (1.06 ± 1.30 versus 4.53 ± 3.43, P &amp;lt; 0.001). Majority of patients were satisfied/very satisfied with the service (n = 77, 94.5%). A lower number of TRPs at follow-up (B = −0.438; t = −4.477, P &amp;lt; 0.001) and higher number of TRPs agreed upon and implemented (B = 0.553; t = 6.949, P &amp;lt; 0.001) were significantly associated with higher level of patient satisfaction. Conclusion The MMR has proven to be an effective pharmaceutical care service when delivered in a developing country, such as Jordan. It led to high patient satisfaction, which was significantly associated with lower number of TRPs at follow-up.

Investigating the Relationship between Nurses’ Moral Sensitivity and Patients’ Satisfaction with the Quality of Nursing Care

Patient satisfaction is considered as an important indicator of the quality and effectiveness of health system. Moral sensitivity plays an important role in how professional responsibilities and moral decisions are made by nurses. This study aims to investigate the relationship between nurses' moral sensitivity and patients' satisfaction with quality of nursing care. This study is descriptive and analytic. First, nurses in internal, surgical and special wards were selected through census method. Then, patients were selected using quota sampling to the ratio of nurses from each section. Data were collected through Demographic Questionnaires, Patient Satisfaction Instrument and Moral Sensitive Questions. Data were analyzed using SPSS 23. There was a significant positive correlation between nurses' moral sensitivity and patients' satisfaction with quality of nursing care (P < 0.05). The majority of patients (70.5) had moderate level of satisfaction with quality of nursing care. 93.5 of nurses had high moral sensitivity. There was no statistically significant relationship between nurses' moral sensitivity and variables of sex, location of work, marital status, type of responsibility and work shift. Relationship between patient satisfaction and type of admission ward was significant (P = 0.03). Increased moral sensitivity in nurses is effective on improving patients' satisfaction with the quality of nursing care. It is suggested to conduct further research with larger sample size and investigate other factors affecting patient satisfaction in order to ensure the generalizability of research results.

Factors associated with low patient satisfaction in out-of-hours primary care in Denmark - a population-based cross-sectional study

BackgroundLow patient satisfaction with the quality of out-of-hours primary care (OOH-PC) has been linked with several individual and organizational factors. However, findings have been ambiguous and may not apply to the Danish out-of-hours (OOH) setting in which general practitioners (GPs) perform the initial telephone triage. This study aimed to identify patient-related, GP-related and organizational factors associated with low patient satisfaction.MethodsThe study was based on data from a 1-year population-based survey of OOH-PC (LV-KOS) in the Central Denmark Region in 2010–2011. GPs on OOH duty completed an electronic questionnaire in the OOH computer system, and the registered patients received a subsequent postal questionnaire focusing on contact evaluation, waiting time, demographic characteristics and general self-perceived health. Associations were analysed using multivariable logistic regression with dissatisfaction as the dependent variable.ResultsThe patient response rate was 50.6%. For all contact types, 82.5% of the patients were satisfied with the OOH-PC service. More patients were dissatisfied with telephone consultations than with clinic consultations or home visits (8.5% vs. 6.0% and 4.3%, respectively). Contacts assessed by the GP as ‘not severe’ were associated with dissatisfaction for telephone consultations and home visits. Poor general self-perceived health was associated with dissatisfaction for all contact types. Living in urban areas was associated with dissatisfaction for telephone consultations, while unacceptable waiting time was associated with dissatisfaction for all contact types.ConclusionsWe found a high level of patient satisfaction with the OOH-PC service. The only factors affecting patient satisfaction across all contact types were unacceptable waiting time and poor general self-perceived health. For the other investigated factors, patient satisfaction depended on the type of contact. Generally, patients contacting for GP-assessed non-severe health problem and patients living in urban areas were more dissatisfied.

Factors associated with the quality of outpatient service: The application of factor analysis – A case study

ABSTRACT Background: Measuring patient satisfaction is a key factor in assessing the quality of patient care. Patient satisfaction outcomes are affected by many variables. Identifying and analyzing effective factors related to patients’ overall satisfaction constitutes an essential aspect of the study of modern healthcare. Aim: The aim of this study is to determine the factors vital to patients’ satisfaction with outpatient service. Methods: A cross-sectional study design was carried out from April to June 2015, consisting of 945 patients in the outpatient services division of King Fahd Hospital of the Imam Abdulrahman Bin Faisal University. Subjects were selected through the simple random sampling method, and data were collected using a structured questionnaire. The questionnaire was checked for validity and reliability using the Cronbach α coefficient and Reliability analysis. The factor analysis technique was used to find the most significant factors affecting patient satisfaction. Results: Exploratory factor analysis showed that the outpatients’ satisfaction comprised four factors namely, professional care, availability of services, waiting time, and satisfaction of laboratory service. These four factors explained 82% of the total variance of patient satisfaction. Based on the results of the factor analysis, satisfaction with physician services and appointment service was identified as the most important aspects of overall satisfaction. Conclusion: Physician-related services, the waiting time for getting test reports, and the wait time for appointment are the major factors affecting patient satisfaction in the outpatient department. Hence, improving the quality of these factors will improve the overall quality of outpatient services for patients.

Factors affecting patient satisfaction in the health care sector in Serbia

Introduction/Objective. The aim of this paper was to highlight and understand factors that influence the quality of healthcare services in Serbia in private and public health institutions. Methods. The data was collected during May of 2017 and June of 2017 through an on-field questionnaire. Out of 500 questionnaires in total, 406 were completed and returned, resulting in a response rate of 81.2%. Results. The following four most influential factors for patient satisfaction in Serbia?s healthcare sector were identified: admission process, doctor care, staff care, and technology tools. Conclusion. The model describes that 66.2 variance for the doctor care variable is based on three constructs: admission process, technology tools, and staff care. The hypothesis that technology tools will have a positive effect on staff care was not confirmed.

Urinary Incontinence, Patient Satisfaction, and Decisional Regret after Prostate Cancer Treatment: A French National Study

Background: Complications of prostate cancer treatments have a substantial impact on the patient’s quality of life. We evaluated the prevalence of urinary consequences and factors affecting patient satisfaction and decisional regret after treatment. Methods: A retrospective self-administered questionnaire was sent to all members of the National Association of Prostate Cancer Patients in France. Results: From the 226 completed questionnaires received, the following information was obtained: 110 patients underwent surgery only, 29 received radiotherapy plus hormone therapy, 28 received radiotherapy only, and 49 received other combination treatments. The median follow-up period was 58.1 months. After treatment, the presence of urinary incontinence was reported by 34.5% of patients treated by radical prostatectomy, by 10.3% treated by radiotherapy plus hormone therapy, by 17.8% treated by curitherapy or radiotherapy only, and by 38.7% treated by other combination therapy (p = 0.01). The main reasons for decisional regret were the fact that patients received incomplete information about prostate cancer (40%) and consequences of treatment that affected the urinary system (34%). The information received about cancer was considered complete in 32.3% of the satisfied group and 14.3% of the decisional regret group (p = 0.003) and with regard to urinary incontinence the information received was considered complete in 41.4 and 17.4% respectively (p < 0.01). Conclusions: Urinary consequences of prostate cancer treatment are common and impact the quality of life. Patients need clear information to be able to participate in therapeutic decision-making and to avoid subsequent decisional regret.

Lighting of a cardiac intensive care unit: Emotional and visual effects on patients and nurses

This study discusses the emotional and visual effects of the luminous environment of cardiac intensive care units on both patients and nurses. We draw the following conclusions: (1) the light level, colour temperature, and lighting design all affect the satisfaction of both patients and nurses. (2) Although patients prefer a low colour temperature, nurses prefer a high colour temperature. The influence of colour temperature on the satisfaction of patients and nurses is smaller than factors such as light level and light distribution. (3) Major factors affecting patient satisfaction consist of an emotional factor and a visual factor in inverse correlation under several particular influences. (4) Nurse satisfaction approximates the visual factor score. (5) The visual factor scores of the subjects (patients and nurses) are in apparent positive correlation with light level. (6) In a scenario characterized by an illuminance of 200 lx, the trends in patients’ emotional factor and visual factor intersect where the emotional factor peaks. However, when the illuminance and average luminance grow further, the emotional factor score decreases.

A Study on the Emotional and Visual Influence of the CICU Luminous Environment on Patients and Nurses

Cardiovascular diseases loom large in China and studies indicate an appropriate luminous environment helps to boost the emotions of cardiovascular patients. This study discusses emotional and visual influences of the luminous environment of Cardiac Intensive Care Units (CICU) on both patients and medical care personnel. We draw the following conclusions: 1) Illuminance level, color temperature, and lighting method all affect patient and nurse satisfaction. 2) Patients prefer low color temperature, while nurses prefer a higher one; however, factors such as illuminance, lighting method, and luminance distribution outweigh the influence of color temperature. 3) The major factors affecting patient satisfaction consist of the emotional and the visual factors in inverse correlation. 4) Nurse satisfaction correlates to the visual factor score. 5) The visual factor scores of subjects (patients and nurses) correlate positively to illuminance levels and average luminance. 6) In a specific range, the visual factor scores of subjects correlate positively to luminance contrast and UGR. 7) In a scenario characterized by an illuminance of 200 lx or an average luminance of 60 cd/m2, the trends of patients′ emotional factor and visual factor intersect, where the emotional factor peaks. 8) For the patients and nurses in CICU, their lighting demands varied due to different purposes. Patients needed to rest while nurses needed to see things clearly at work. In our opinion, the CICU Luminous Environment should be adapted to the needs of different major users (patients or nurses) with controlled parameters to achieve ideal performance. However, when illuminance and average luminance grow beyond the peak, the emotional factor will decrease.

P116: A scoping review of factors affecting patient satisfaction with care in North American adult emergency departments

Introduction: Patient satisfaction in the emergency department (ED) has been shown to be associated with patient compliance, likelihood to return, and likelihood to recommend the ED. Understanding the factors that affect patient satisfaction in the ED is important but remains poorly understood. This scoping review consolidates the information from the available literature to offer insight into which key factors influence patient satisfaction. Methods: A literature search using initial criteria identified 683 articles. These titles were subjected to inclusion/exclusion criteria and their relevance was independently reviewed by two authors. Consensus was reached on 24 articles to be included, and these were then classified according to study design (class I=observational studies, class II=focus group/qualitative studies, class III=reviews), as well as multiple other factors (ED type, volume of patients, sample size, population, type of study, methodology, study measures, statistical analysis, reliability and conclusions). Using these factors, 25 different ED care attributes were examined in the primary literature, and then narrowed to the 6 most commonly studied factors with 3 categories (wait times, communication/information received in the ED, and interpersonal skills of staff). Results: The impact of wait times (WT) on patient satisfaction in the ED was addressed in 58% of the articles and various studies have found that longer perceived WTs (the length of WTs as reported by patients) are associated with poorer patient satisfaction. Information delivery demonstrated statistically significant associations to both patient satisfaction and the likelihood of a positive recommendation. Interpersonal skills of the staff also demonstrated a strong association with patient satisfaction. Conclusion: The most common factors affecting patient satisfaction in the ED can be categorized under wait times, communication, and the interpersonal skills of the staff. However, the literature in this area is weak, and well-designed comparative studies of the relative importance of each of these factors are necessary to support evidence-based policy making and ultimately improve patient satisfaction.

Factors Affecting Quality of Health Service and Patient Satisfaction in Community Health Centers in North Lampung, Sumatera

Background: Quality of health service and patient satisfaction are an important element in providing a health service. Assessing and evaluating a health service based on user perceptions are important for continuous improvement of health services. This study aimed to examine the factors affecting the quality of health service and patient satisfaction in community health centers in North Lampung, Sumatera, Indonesia. Subjects and Method: This was an analytic observational study with a cross-sectional design. This study was conducted in 25 community health centers in North Lampung, Sumatera, in January 2017. A total sample of 200 out-patients was selected for this study by simple random sampling and stratified random sampling for community health center. The dependent variables were quality of service and patient satisfaction. The independent variables were education, income, a frequency of visit, and accreditation status of community health center. The contextual effect was measured by accreditation status of community health center. The data were collected by questionnaire and analyzed by linear regression multilevel model. Results: Factors affecting quality of health service were income (b= -1.09, 95% CI= -5.71 to 3.52, p = 0.641), education (b = -11.48, 95% CI= -16.07 to -6.88, p< 0.001), and frequency of visits (b=6.88, 95% CI= 2.53 to 11.23, p=0.002). Intraclass correlation= 6%. Factors affecting patient satisfaction were income (b= -1.07, 95% CI= -1.58 to -0.56, p<0.001), education (b= -0.77, 95% CI= -1.31 to -0.23, p=0.005), frequency of visits (b= 0.88, 95% CI= 0.39 to 1.38, p<0.001), and quality of service (b=0.04, 95% CI= 0.02 to 0.06, p<0.001). Intraclass corelation= 13.79% indicating considerable contextual effect of accreditation status of community health center. Conclusion: Quality of service is affected by income, education, and frequency of visits in community health center. Patient satisfaction is affected by income, education, a frequency of visits, and quality of service. Accreditation status of community health center has a considerable contextual effect on patient satisfaction. Keywords: quality of service, patient satisfaction, accreditation status, community health center, multilevel analysis Correspondence: Mulia Yuli Widayati. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36 A Surakarta. Email: muliayuli@yahoo.co.id Journal of Health Policy and Management (2017), 2(2): 165-175 https://doi.org/10.26911/thejhpm.2017.02.02.08

Analysis of Factors Affecting Patient Satisfaction JKN Non PBI at Primary Health Care in East Jakarta District 2016

Health development in the period 2015-2019 is Indonesia Sehat program with the goal to improve the health and nutritional status of the community through health and community empowerment efforts which are supported with financial protection and health care equity. Social Health Security Agency (BPJS) as JKN organizers estimate in 2015 is a deficit of more than 6 trillion rupiahs. In 2016, the deficit is estimated to be 11 trillion rupiahs. This study used a cross-sectional study design. The population in this study were outpatients at the sub-district Kramat Jati and Pasar Rebo primary health care with the total number of 800 people and studied sample of 100 people. Patient satisfaction in this study has mean score of 43,06. Education variable; job and services are not significantly affects patient satisfaction JKN Non PBI at East Jakarta district primary heallth care. In conclusion, dimension of punctuality; convenience in obtaining services and ease in obtaining services most influence on patient satisfaction JKN Non PBI in East Jakarta district primary health care with the p value = 0,000 &lt; 0,05. In addition, politeness and friendliness within the service still have big influence on patient satisfaction bicause it is important factors on patient satisfaction. Therefore, the author gives some recommendations to appropriate and thorough improvement added with upgrading to the punctuality of service, conducting a survey of patient satisfaction by BPJS and primary health care, disseminating the research results regarding the effect of service quality on patient satisfaction level, further and in-depth research needs to be done related to the effect on service quality dimension to JKN patient satisfaction level in all primary health care included in East Jakarta district, especially at primary health care which has never been conducted with survey and research on JKN patient satisfaction level.

Preoperative and Postoperative Factors Affecting Patient Satisfaction After Total Knee Arthroplasty

Amac: Bu calismada total diz artroplastisinden (TDA) 12 hafta sonra hasta memnuniyetinin degerlendirilmesi ve TDA sonrasi kisa donem hasta memnuniyetini etkileyen preoperatif ve postoperatif faktorlerin saptanmasi amaclanmistir. Materyal ve Metot: Primer TDA yapilan 40 hasta calismaya alindi. Hastalar Western Ontario ve Mc Masters Universiteleri Osteoartrit Indeksi, Kisa Form-36 (SF36), Gorsel Analog Skala (Visual Analog Scale, VAS)-agri, 50 metre yurume testi ile ameliyat oncesi ve TDA’dan 12 hafta sonra degerlendirildi. Pre ve postoperatif diz fleksiyon ve ekstansiyon eklem hareket acikliklari (EHA) kaydedildi. Postoperatif hasta memnuniyeti degerlendirildi. Bulgular: Preoperatif donemde gruplar arasinda memnun ve memnun olmayan hastalar arasinda yas, VAS-agri, SF36 alt skorla- ri, aktif ve pasif EHA’lar acisindan fark yoktu (p>0,05). Postoperatif donemde memnun hasta grubunda VAS-agri ve SF36 genel saglik ve fiziksel-emosyonel rol alt skorlari dusuk, pasif diz fleksiyonu ise yuksekti (p 0,05). Sonuc: Preoperatif agri, disabilite ve yasam kalitesinin postoperatif kisa donem hasta memnuniyeti uzerine etkisi yoktu. Postoperatif do - nemdeki agri siddeti, diz fleksiyon EHA derecesi ve yasam kalitesinde bozulmanin hasta memnuniyeti uzerine belirgin negatif etkisi mevcut - tu. TDA sonrasi memnuniyetsizlikle iliskili faktorlerin genis olcude net - lestirilmesi icin daha cok hasta iceren calismalara gereksinim vardir.

Measuring patient's satisfaction of healthcare services in the UAE hospitals: Using SERVQUAL

The purpose of this paper is to evaluate the quality of healthcare services by investigating the factors affecting patient satisfaction in private and public hospitals in the UAE based on five service quality dimensions of the SERVQUAL namely; tangibles, reliability, responsiveness, assurance, and empathy. A modified SERVQUAL questionnaire was used to gather the research data. The respondents of the study consisted of 127 patients who have been admitted within the last 6 months prior to the onset of the investigation. The results of the study revealed that the perceived healthcare services in private hospitals and public hospitals do not significantly vary. Although patients were more satisfied with nursing care, the perceived satisfaction of patients with the quality of services provided by physicians and nurses as well as the quality of the hospital environment do not significantly vary in both public and private hospitals. The dimension of assurance was rated the highest while responsiveness was perceived as the least important of the five SERVQUAL dimensions. The five dimensions of the SERVQUAL appeared to be a consistent and reliable scale for measuring healthcare service quality in the United Arab Emirates context. The modified SERVQUAL may be used to contribute in enhancing the quality of healthcare services in UAE and in other similar environments.

Determinants for patient satisfaction regarding aesthetic outcome and skin sensitivity after breast-conserving surgery.

BackgroundWith the development of new surgical techniques in breast cancer, such as oncoplastic breast surgery, increased knowledge of risk factors for poor satisfaction with conventional breast-conserving surgery (BCS) is needed in order to determine which patients to offer these techniques to. The aim of this study was to investigate patient satisfaction regarding aesthetic result and skin sensitivity in relation to patient, tumour, and treatment factors, in a consecutive sample of patients undergoing conventional BCS.MethodsWomen eligible for BCS were recruited between February 1, 2008 and January 31, 2012 in a prospective setup. In all, 297 women completed a study-specific questionnaire 1 year after conventional BCS and radiotherapy. Potential risk factors for poor satisfaction were investigated using logistic regression analysis.ResultsThe great majority of the women, 84%, were satisfied or very satisfied with the overall aesthetic result. The rate of satisfaction regarding symmetry between the breasts was 68% and for skin sensitivity in the operated breast it was 67%. Excision of more than 20% of the preoperative breast volume was associated with poor satisfaction regarding overall aesthetic outcome, as was axillary clearance. A high BMI (≥30 kg/m2) seemed to affect satisfaction with symmetry negatively. Factors associated with less satisfied patients regarding skin sensitivity in the operated breast were an excision of ≥20% of preoperative breast volume, a BMI of 25–30 kg/m2, axillary clearance, and radiotherapy. Re-excision and postoperative infection were associated with lower rates of satisfaction regarding both overall aesthetic outcome and symmetry, as well as with skin sensitivity.ConclusionsSeveral factors affect patient satisfaction after BCS. A major determinant of poor satisfaction in this study was a large excision of breast volume. If the percentage of breast volume excised is estimated to exceed 20%, other techniques, such as oncoplastic breast surgery, with or without contralateral surgery, or mastectomy with reconstruction, may be considered.Electronic supplementary materialThe online version of this article (doi:10.1186/s12957-016-1053-8) contains supplementary material, which is available to authorized users.