Group Differences In Satisfaction Research Articles

The Association of Patient Relationship Style and Outcomes in Collaborative Care Treatment for Depression in Patients With Diabetes

We sought to determine whether relationship style in patients with diabetes receiving depression treatment is associated with differential quality of care and depression outcomes. From 9 health maintenance organization clinics, 324 primary care patients with diabetes and comorbid major depression and/or dysthymia participated in the Pathways randomized controlled trial of collaborative care for depression (n = 160) versus usual care (n = 164). The intervention provided outreach, enhanced support of antidepressant medication use, and problem-solving treatment delivered by nurse case managers. Using attachment theory principles, we categorized patients as having an independent (n = 190) or interactive (n = 134) relationship style. We assessed whether patient relationship style moderated treatment group differences in quality of care and depression outcomes. Among independent relationship style patients, the intervention resulted in significantly greater satisfaction with depression care in the first 6 months and 47 more depression-free days (P < 0.0003) based on the Hopkins Symptom Checklist at 12 months, compared with usual care. There were no significant treatment group differences in satisfaction with care or depression outcomes among patients with interactive relationship style. Among patients receiving the intervention, those with an independent relationship style received significantly more problem-solving treatment sessions as compared with patients with an interactive relationship style. Among depressed patients with diabetes, the Pathways collaborative care intervention improved quality of care for depression compared with usual care in both relationship style groups but was associated with significantly better depressive outcomes and greater satisfaction with care compared with usual care in patients with independent but not interactive relationship style.

BODY-IMAGE ATTITUDES AND PSYCHOSOCIAL FUNCTIONING IN EURO-AMERICAN AND ASIAN-AMERICAN COLLEGE WOMEN

Euro-American (n = 94) and Asian-American (n = 72) college women were compared on multiple dimensions of body image, including global body satisfaction, preoccupation with appearance, satisfaction with individual body parts or features, and weight concern, and psychosocial functioning, including self-esteem, public self-consciousness, social anxiety, and public body consciousness. Both groups reported similar scores on these variables and showed similar patterns of correlations between body-image and psychosocial variables. Despite similar global body satisfaction, there were group differences in satisfaction with individual body parts or features, with Asian-American women reporting lower satisfaction with six parts or features and higher satisfaction with one feature. Stepwise multiple regression analyses predicting global body satisfaction from individual body parts or features suggested that both the specific body parts or features most salient to global body satisfaction and the relative influence of these parts or features varied as a function of ethnicity. Implications of these findings for research and practice are discussed.

Asian versus western differences in satisfaction with western medical care: The mediational effects of illness attributions

This study examined Asian versus Western students' satisfaction with Western medical care. and the extent to which differences in satisfaction are mediated by culture-specific “illness models”. Seventy-nine Westem (largely Canadian-born; 27 males, 53 females) and 63 Asian (first and second generation immigrants; 31 males. 32 females) undergraduates completed measures assessing satisfaction with Western medical care and views about causes of illness. Results were consistent with predictions. Asian participants were less satisfied with the health care they had resaved in Canada, and believed more strongly in non–biological causes of illness (i.e., “balance” and supernatural and interpersonal influences) than did Western participants. Moreover. illness beliefs Partly mediated the group differences in satisfaction with Western medical care.

The National Health Service Corps Experience for Rural Physicians in the Late 1980s

To learn from physicians in the National Health Service Corps (referred to as NHSC or the Corps) scholarship program about their experiences in rural health professional shortage areas (HPSAs), to contrast their experiences with those of other physicians working in rural HPSAs, and to learn how NHSC physicians' retention is associated with the quality of their experiences. Cohort study. Two groups of primary care physicians who moved to rural HPSAs nationwide from 1987 through 1990 were surveyed in 1991: group 1 consisted of all 675 physicians in the NHSC scholarship program, and group 2 consisted of a stratified random sample of 1000 non-Corps physicians. Response rates were 73.7% and 69.1%, respectively. Analyses used comparable subsets of 417 NHSC and 206 non-NHSC respondents. Among NHSC physicians, 51% initially anticipated working in underserved areas longer than 10 years, although only 14% expected to remain more than 5 years in their assigned practices. Three quarters of the Corps group felt there were few acceptable practice sites available to them, one third likely would have preferred urban sites, and two thirds were matched in states where they had not lived or trained earlier. Corps physicians felt their spouses' and children's needs were less well satisfied in their communities than non-Corps physicians. Corps physicians reported lower satisfaction in their work and personal lives and demonstrated poorer retention. Group differences in satisfaction and retention remained after controlling for various features of physicians and sites where they worked. Among NHSC physicians, retention was dramatically lower for those less well matched to their communities and those less satisfied. The needs and preferences of NHSC physicians and families are not well accommodated. Low morale and poor retention are endemic among NHSC physicians. The NHSC is challenged by twin goals of meeting the immediate needs of underserved communities and providing personally and professionally satisfying environments where physicians can pursue long-term careers.

Married women's dissatisfaction with tubal sterilization and vasectomy at first-year follow-up: effects of perceived spousal dominance

Examination of first-year follow-up data obtained from 234 tubal ligation women and 154 vasectomy wives indicated a very low incidence of actual regret in both groups. However, use of a broader measure of satisfaction/dissatisfaction indicated that tubal ligation women had significantly more positive feelings about the sterilization decision than did vasectomy wives. Results of a series of multivariate statistical analyses demonstrated that group differences in satisfaction were related to (1) the disproportionate prevalence of perceived male control (particularly extensive control) over reproductive decisions among vasectomy wives and the negative effect it had upon subjects in both groups and (2) the disproportionate prevalence of female control over reproductive decision-making among tubal ligation women and the positive effect it had among subjects in this group. Study results point to the importance of couple counseling and exercising control over one's own body.

Effects of acquiescent response set on patient satisfaction ratings.

This paper summarizes the results of three studies of bias in patient satisfaction questionnaires due to acquiescent response set (ARS), a tendency to agree with statements of opinion regardless of content. Three independent surveys (N = 1,280) were fielded using the Patient Satisfaction Questionnaire. Across the three field tests, 40 to 60 per cent of respondents manifested some degree of ARS and from 2 to 10 per cent demonstrated noteworthy ARS tendencies. Occurrences of ARS accounted for significant upward bias in satisfaction scores computed from favorably worded questionnaire items and scales constructed from those items and significant downward bias in scores computed from unfavorably worded items and scales constructed from those items. These biases were greatest for groups reporting lower educational attainment or less income. An example was presented to show that mean satisfaction scores for groups differing in education were biased by ARS to such an extent that group differences in satisfaction were overestimated by favorably worded items and were missed entirely by unfavorably worded items. Balanced satisfaction scales, i.e., those containing both favorably and unfavorably worded items, were not correlated or correlated only slightly with ARS; therefore, group means for balanced scales were not biased by ARS or were biased only slightly.