Interpersonal Manner Research Articles

A survey of patient satisfaction of patients attending a psychiatry outpatient clinic at a tertiary care centre

Background: The concept of patient satisfaction in mental health services has eluded understanding in spite of large research body on this subject. Poor patient satisfaction leads to worse outcomes on psychiatric disorders. This study looked for social, demographic and clinical variables associated with patient satisfaction.Methods: 1100 eligible subjects were screened and then 519 alternate sample subjects were recruited for the survey based on the selection criteria. Social, demographic and clinical variables were assessed and PSQ-18 (Patient Satisfaction Questionnaire) was administered to all subjects.Results: 453 (87.28%) patients reported satisfaction and 66 (12.72%) of patients reported being unsatisfied with the service provided. Four sub-scales [“General satisfaction” (p<0.001), “Technical quality” (p<0.001), “Interpersonal manner” and “Communication” were found to be associated with patient satisfaction while other 3 sub-scales (“Financial aspects”, “Time spent with the doctor” and “Accessibility and convenience”) were not significantly associated with patient satisfaction.Conclusions: Both the technical and the interpersonal and communication skills of the doctor were important in determining patient satisfaction whereas the often believed variables like financial aspect and the time spent with the doctor did not affect patient satisfaction significantly.

Patient satisfaction in health care facility in hilly areas of Uttarakhand

Background: Patient satisfaction is a proxy indicator of the quality of doctor or hospital performance. The present study aimed at to assess the patient satisfaction in the outpatient department of rural and urban health training centre, Uttarakhand, North India.Methods: A hospital based cross sectional study. Simplified questionnaire was used for interviewing patients. For measurement of patient satisfaction in the outpatient department patient satisfaction questionnaire 18 was used with additional indices for nursing and paramedical staff.Results: A total of 200 patients participated in the study. Overall majority of them were females 112 (60%). Mean age of the patients was 40.4±19.5 years. Mean distance travelled to reach health facility was 13.5±21.6 km. The mean score for general satisfaction was 3.96±0.63, for financial aspects was 3.82±0.71, for accessibility and convenience was 3.81±0.65, for interpersonal manner of doctor 4.29±0.78, for communication of doctor 4.38±0.67, for technical quality was 4.05±0.58 and for time spent during the visit was 4.21±0.70. In the hierarchical stepwise multiple linear regression analysis the final model explained 85% of the variance in patient satisfaction.Conclusions: Overall, patients expressed satisfaction with the care provided. These ratings may reflect modest patients' expectations as well as acceptable circumstances and performance.

Modifikasi Patient Satisfaction Questionnaire Short Form (PSQ-18) ke dalam Bahasa Indonesia

This research purpose to develop a valid and reliable patient satisfaction tool. The modification procedures include: preparation, practice, and finalization. The result of modification is called Patient Satisfaction Questionnaire 2017 (KKP-2017). Aspects in KKP-2017 include: interpersonal manner, technical quality/professionalism behavior, accessibility/convenience, financial aspects, and physical environment. Data analysis includes content validity, item scale correlation and reliability. The result of content validity in 82 items cover three questionnaire formats which include KKP-2017 Format 40, Format 25, and Format 10. Items selection is considered by correlation coefficient > 0,3 that yield 40 items with reliability estimation 0,936, KKP-2017 Format 25 with reliability estimation 0.928 and KKP-Format 10 with reliability estimation 0.883. KKP-2017 can be used to measure the level of patient satisfaction in hospital services.

Patient satisfaction at a primary level health-care facility in a district of West Bengal: Are our patients really satisfied?

Introduction: Many recent studies have shown an increased association between patient's satisfaction levels, patient's compliance, and success of treatment. Aim: The aim of this study is to assess the level of satisfaction among patients who have utilized the outpatient department services provided in the primary care level health institution. Materials and Methods: A health center-based observational cross-sectional study was conducted from July 2011 to October 2011 at Guskara Primary health center, Burdwan among 422 patients using a pre-designed pre-tested structured schedule. Results: Overall, mean satisfaction score was 2.97 ± 0.37. Highest satisfaction scores were observed among 18–20 years, males were more satisfied regarding technical quality of care, whereas females reported higher satisfaction regarding interpersonal manner, unmarried/single group reported the highest satisfaction with most of the services, literate group reported higher satisfaction than the illiterate group, affluent patients reported higher satisfaction regarding technical quality of care, financial aspect. Conclusions: Causes of dissatisfaction were long waiting time, the inadequacy of seating arrangement in the waiting area, inadequate cleanliness of surroundings, inadequate toilet facilities, nonavailability of medicines, and behavior of doctor.

Evidence for arrogance: On the relative importance of expertise, outcome, and manner.

Arrogant behavior is as old as human nature. Nonetheless, the factors that cause people to be perceived as arrogant have received very little research attention. In this paper, we focused on a typical manifestation of arrogance: dismissive behavior. In particular, we explored the conditions under which a person who dismissed advice would be perceived as arrogant. We examined two factors: the advisee’s competence, and the manner in which he or she dismissed the advice. The effect of the advisee’s competence was tested by manipulating two competence cues: relative expertise, and the outcome of the advice dismissal (i.e., whether the advisee was right or wrong). In six studies (N = 1304), participants made arrogance judgments about protagonists who dismissed the advice of another person while the advisees’ relative expertise (compared to the advisor), their eventual correctness, and the manner of their dismissal were manipulated in between-participant designs. Across various types of decisions and advisee-advisor relationships, the results show that less expert, less correct, and ruder advisees are perceived as more arrogant. We also find that outcome trumps expertise, and manner trumps both expertise and outcomes. In two additional studies (N = 101), we examined people’s naïve theories about the relative importance of the aforementioned arrogance cues. These studies showed that people overestimate the role of expertise information as compared to the role of interpersonal manner and outcomes. Thus, our results suggest that people may commit arrogant faux pas because they erroneously expect that their expertise will justify their dismissive behavior.

Levels and predictors of patient satisfaction with doctor home-visit services in Australia.

The Australian after-hours house-call (AHHC) services has grown rapidly in the past few years. Even though recent studies have looked at aspects of the service as it concerns the medical personnel involved, no national study has explored patient satisfaction with the service. This study aims to assess patient satisfaction with Australian AHHC services and its predictors, with the hope of improving quality and patient outcomes. The findings might also have international relevance, given the developing nature of the AHHC in most countries. A cross-sectional survey of all 10838 patients known to have patronized the AHHC service in Australia over a 1-week period. The main outcome measure was the Patient Satisfaction Questionnaire 18 (PSQ-18). A total of 1228 questionnaires were returned. General Satisfaction (GS) level was found to be 85.2% (mean 4.16/5). Other Scales of Satisfaction, in decreasing order, were 'Financial Aspects, FA' (87.4%; 4.36/5), 'Communication, CM' (87.3%; 4.18), 'Technical Quality, TA' (82.1%; 4.09), 'Time Spent with Doctor, TSD' (77.7%; 3.91), 'Interpersonal Manner, IM' (75.7%; 3.87) and 'Accessibility and Convenience, A&C' (72.9%; 3.82). The major predictor of increased satisfaction was the time it took the doctor to arrive, with increased satisfaction on GS (T < 4 hours; P < 0.01), IM (T < 30 minutes; P = 0.03), FA (T < 2 hours; P = 0.01), TSD (T < 2 hours; P < 0.01) and A&C (T < 4 hours; P < 0.01). Other positive predictors of aspects of satisfaction included 'being a student', 'age of patient ≤ 16' and 'being Australian born', while 'being on a pension' was negatively associated with Communication (P = 0.03). No associations were found with gender, marital status, employment status, family income or having children in the household. This study concludes that satisfaction in Australian AHHC is high on all scales but recommends that the service providers should aim to attend to patients within 4 hours of their initial calls.

Assessment of client satisfaction among HIV/AIDS patients attending selected ART centers of Indore and Ujjain division of MP

Background: ART centers are the corner stone for providing care to HIV patient and it is very essential part of HIV/AIDS control programme in India. Objectives: To study the satisfaction level of Beneficiaries and Attendants of the Children receiving care at ART centers. Methodology: A cross-sectional study was conducted with the help of Pre-designed, Pre-tested, Semi-structured questionnaire for Beneficiaries and legal guardian of Children receiving care at ART centers to assess the satisfaction level for services, using Likert Scale and PSQ-18 during the period between 01 January 2015 – 31 October 2015 .Simple random sampling for selection of ART centers and Sequential sampling for the Beneficiaries and legal guardian of the Children receiving care at ART centers. A total of 110 patients were included in the study. Results: In study sites, satisfaction with behaviour of staff was highest, 92 % and only 5 % were dissatisfied, 90 % of clients were satisfied with infrastructure and facilities, 83.6% of clients were satisfied with communication and interpersonal manner, lowest satisfaction 45%was observed for ART side effects and tolerance. On basis of PSQ18 Questionnaire the mean score for General Satisfaction was 3.18 (SD 0.71), Technical Quality 2.89 (SD 0.84), Interpersonal Manner 3.08 (SD 0.81), Communication 3.00(SD 0.85), Financial Aspects was 2.67 (SD 0.91), Time Spent during the visit, 2.99 (SD 0.92), for Accessibility and Convenience 2.52 (SD 0.91). Conclusions: overall Satisfaction level of beneficiaries was good, although there were some places for improvement i.e. traveling, waiting area.

Improving quality in healthcare: What makes a satisfied patient?

ObjectiveTo update the metric properties of a perceived quality questionnaire for patients admitted to hospital medical departments, to determine the level of patient satisfaction achieved, and to identify the variables which predict satisfaction. MethodsSelf-administered questionnaire completed at home following patient discharge, using a questionnaire prepared by the authors on a sample of 7207 users of medical departments in 9 public hospitals during the years 2006–2009. A principal component analysis with varimax rotation was performed. Reliability was assessed using internal consistency coefficient. An analysis was made of the compliance with each indicator reported by respondents. A logistic regression analysis was performed to determine the perceived quality dimensions which predicted overall patient satisfaction. ResultsThe results of the reliability analysis indicated good coefficients for interpersonal manner (0.94) and professional competence (0.85) dimensions, and moderate values for the other dimensions (comfort 0.55, information 0.38, and organisation 0.37). Factor analyses showed single factors in each of the perceived quality dimensions, with a percentage of explained variance greater than 35% for information, interpersonal manner, professional competence, and comfort, and less than 30% for organisation. The dimensions which predicted satisfaction were interpersonal manner of healthcare staff, professional competence, and information. ConclusionsThe metric properties of the questionnaire used have been updated, yielding a valid and reliable questionnaire for assessing patient satisfaction in quality management programmes, both for internal purposes and for conducting external comparisons.A positive relationship was obtained between the level of patient satisfaction and level of professional competence, interpersonal manner of healthcare staff, and information received.

Level of Satisfaction Among People Living with HIV (PLHIV) Attending the HIV Clinic of Tertiary Care Center in Southern India.

Patient satisfaction is an important issue for the health care sector. Hospitals routinely collect patient satisfaction data so that they can improve the quality of their services. There is a dearth of research in the field of satisfaction among people living with HIV (PLHIV) in India. The aim of our study was to determine the level of satisfaction among PLHIV attending the HIV clinic of tertiary health centre in Southern India. This descriptive cross-sectional study was done in the HIV clinic attached to Kasturba Medical College (KMC) Hospital, Mangalore, India from August 2012 - August 2013. PLHIV of age more than 18 years were included. During the study period 422 consecutive patients who consented for the study were enrolled. To determine patient satisfaction towards healthcare service, we used the Short Form Patient Satisfaction Questionnaire (PSQ-18). Data was analysed using SPSS Version 11.5 statistical software. A total of 422 patients were included in the study out of whom 253(60%) were males and 169(40%) were females. Mean age of the patients was 37.08±7.2 years. The median CD4 count was 345 cells/mm(3) (IQR 245-451.2). The mean score for general satisfaction was 4.43±0.48, for technical quality 4.77±0.26, for interpersonal manner 4.59±0.4, for communication 4.64±0.42, for financial aspects 3.20±0.78), for accessibility and convenience 4.50±0.72 and for time spent with the doctor was 4.59±0.45. Subscale scores for general satisfaction, technical quality, accessibility, interpersonal manner, finance and communication were higher in females when compared to males which were found to be statistically significant. Younger PLHIV (≤ 35 years) had significantly higher scores in technical quality, interpersonal manner and time spent with the doctor when compared to older PLHIV. Patient satisfaction was highest for technical quality and it was lowest for financial aspects. If hospitals wish to improve the quality of health services they should give priority to decreasing costs and improving accessibility.

The Relationship between the Motivation for Physical Activity and Life Skills among Chinese and Japanese College Students

Participation in physical activity is beneficial for health and motivation is an important theme in sport psychology. The purpose of this study was to examine the difference of the relationship between the motivation for physical activity and daily life skills among Chinese and Japanese college students. A questionnaire survey was conducted for 1039 college students (Chinese, n = 526; Japanese, n = 513). Japanese and Chinese version of Physical Activity and Leisure Motivation Scale (PALMS, 1, 2) and a Daily Life Skills Scale for College Students (DLS, 3, 4) were completed by the participants. The PALMS includes eight sub scales which are Mastery, Physical Condition, Affiliation, Psychological Condition, Appearance, Others’ Expectations, Enjoyment and Competition/Ego. DLS includes 8 sub-scales, which are classified into 2 general skills: skills used mainly in personal situations (planning, knowledge summarization, self-esteem, and positive thinking), and skills used generally in interpersonal situations (intimacy, leadership, empathy, and interpersonal manner). The Chinese version of “Daily Life-Skills Scale” created in this study was confirmed, Significant differences between Chinese and Japanese University students were observed. Chinese college students had a higher mean score for the intimacy factor, leadership factor, planning factors, knowledge summarization factor and self-esteem factor. While Japanese college students had a higher mean scores for the aspects of empathy and interpersonal manner. This study found different relationships between the motivation for physical activity and daily life skills among Chinese and Japanese college students. It might be due to cultural differences between those countries. Future research should be focusing on gender and cultural differences of both countries regarding to the motivation for leisure.

Evaluation of Patient Satisfaction with Medical Services at Traditional Iranian Medicine Clinics in Tehran

Introduction: Evaluation of patient satisfaction is a common method used to determine the quality of medical services. This study aimed to assess the level of satisfaction in patients referring to the clinics of traditional Iranian medicine affiliated to Tehran University of Medical Sciences (TUMS), Iran. Materials and Methods: This cross-sectional study was conducted on 260 patients with history of at least two referrals to the clinics of traditional medicine at TUMS. Subjects completed the Persian version of Patient Satisfaction Questionnaire (PSQ-18). Data analysis was performed using T-test, Chi-square, ANOVA and Pearson’s correlation coefficient. Results:Out of 260 patients with the mean age of 41.01±12.95 years, 104 patients (63.1%) were satisfied, 9 (3.4%) were completely satisfied, 67 (25.8%) were dissatisfied with the medical services, and 20 patients (7.7%) were uncertain. In subscales of access to physician, time spent with doctor, interpersonal manner and overall satisfaction, number of satisfied patients was higher than their dissatisfied counterparts. However, rate of dissatisfaction was higher in subscales of technical quality, communication and financial aspects of care. Moreover, no statistically significant relationship was observed between satisfaction scores and age, gender, education status, type and duration of disease and marital status of the subjects. Conclusion: According to the results of this study, over 60% of the patients were satisfied with the health care services offered at traditional medicine clinics. Insurance coverage for traditional treatments could significantly reduce treatment costs. Furthermore, technical quality and communication skills of practitioners need to be improved through training courses in the field of traditional medicine.

Abstract A92: Patients' experiences with breast cancer care: Do sociocultural factors attenuate racial disparities in ratings of quality?

Abstract Background: Several studies have reported disparities in access to quality cancer care in women from racial/ethnic groups compared to non-Hispanic whites. Few reports examine the factors associated with breast cancer patients' ratings of quality care. The goal of this study is to (1) assess racial disparities in patients' ratings of quality care and (2) identify factors that may attenuate these disparities. Methods: We surveyed and abstracted medical records for 359 breast cancer patients (59% black; 41% white) in Washington, DC and Detroit, MI. Ratings of quality of cancer care were assessed for four domains (general satisfaction, technical quality, interpersonal manner, and financial aspects). Results: Black women were more likely to report lower ratings on three dimensions including technical (black m=3.99; white m=4.27; p&amp;lt;.001), interpersonal (black m=4.17; white m=4.36; p&amp;lt;.01), and financial (black m=3.82; white m=4.01; p&amp;lt; .05). General satisfaction ratings: In bivariate analysis, women with higher ratings were those who made surgery decisions with the physician, reported fewer barriers to use health care services (appointment, physical, and emotional barriers) perceived lower discrimination, lower medical mistrust, had high health self-efficacy (maintaining a positive attitude, seeking information, and participating in care), and had high trust in their providers and oncologist (all p&amp;lt;.05). In multivariate analysis, only trust in the oncologist (B=.085, SE=.04, p=.033), trust in providers (B=.069,SE=.02, p=.00), and appointment barrier (B=-.32, SE=.15, p=.04) remained significant. Technical care ratings: In bivariate analysis, women with higher ratings were those who made decisions about treatment with the physician, were in racially concordant patient-provider relationship, had lower perceived discrimination, lower medical mistrust, higher trust in the providers and in the oncologist, and did not endorse limited office hours or emotional barriers. Additionally, self-efficacy (the three subscales) was associated with higher ratings (all p&amp;lt;.05). In multivariate analysis, medical mistrust (B=-0.20, SE=.007, p=.003) and trust in provider remained significant (B=.083, SE=.011, p=.000). Interpersonal care ratings: Factors associated with higher ratings in bivariate analysis included: oncologist race concordance, high trust in oncologist and in the provider, high self-efficacy (participating in care). Participants who reported more barriers (limited office hours and health insurance in particular), those with lower perceived discrimination, lower medical mistrust, and lower ratings of communalism had higher ratings of interpersonal care (all p&amp;lt;.05). Only trust in provider (B=.05, SE= .012, p=.000) and total number of barriers (B= -.057, SE=.019, p=.003) remained significant in multivariate analysis. Financial aspects of care ratings: In bivariate analysis, number of barriers (appointment, health insurance, money, physical, and emotion in particular), religiosity, perceived discrimination, self-efficacy (positive attitude and participating in care), medical mistrust, trust in providers and in oncologist were significantly related to ratings of financial aspects of care (all p&amp;lt;.05). In multivariate analysis, perceived discrimination (B=-.067, SE=.028, p=.019), trust in provider (B=.053, SE=.013, p=.000), insurance (B=-.491, SE=.162, p=.003) and money barrier (B=-.672, SE=.129, p=.000), and religiosity (B=.017, SE=.007, p=.024) remained significant. Conclusion: Black women reported lower ratings of quality for most domains. Both sociocultural (e.g. communalism) and healthcare process factors (e.g. trust) appear to diminish the impact of race. This study adds to the limited knowledge about black and white women's cancer care experiences and suggests potential intervention targets that may help reduce disparities. Citation Format: Vanessa B. Sheppard, Alejandra Hurtado de Mendoza, Minna Song, Kepher Makambi. Patients' experiences with breast cancer care: Do sociocultural factors attenuate racial disparities in ratings of quality? [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr A92.

Nurse-led outpatient clinics in oncology care – Patient satisfaction, information and continuity of care

PurposeThe aims of the present study were to investigate patients' satisfaction with nurse-led clinics, patients' perception of received information and associations between continuity of care and satisfaction with information. MethodsQuestionnaires on patient satisfaction were sent to consecutive samples of patients after they attended a nurse-led clinic at the Department of Oncology, Karolinska University Hospital in 2007, 2009, 2011 and 2013. Patients' perceptions of received information were evaluated in 2011 and 2013, by the EORTC QLQ-INFO25. Data on registered continuity of care were retrieved from the patients' medical record. ResultsA total of 962 patients responded (79%) to one of the four surveys. Patients' satisfaction with nurse-led clinics was stable over time. More than 90% rated nurses' interpersonal manners and the care at the clinic as “good”, the waiting time as “acceptable”, and the length of appointments as “sufficient”. Over 90% responded that it was important to meet the same nurse and 62% reported they actually did so and 52% stated they were assigned a named nurse navigator. More than 75% rated the information at their latest visit at a nurse-led clinic as “completely” sufficient. However, 48% expressed wish for more information “during the current disease”. No statistical significant associations were found between “satisfaction with information” and continuity of care. ConclusionsPatients' satisfaction with nurse-led clinics was stable over time with generally high figures with the exception for continuity of care and information, areas in which improvements are needed. The wide variety in information needs might require a person-centred approach.

Patient satisfaction in Malaysia's busiest outpatient medical care.

This study aimed to explore factors associated with patient satisfaction of outpatient medical care in Malaysia. A cross-sectional exit survey was conducted among 340 outpatients aged between 13 and 80 years after successful clinical consultations and treatment acquirements using convenience sampling at the outpatient medical care of Tengku Ampuan Rahimah Hospital (HTAR), Malaysia, being the country's busiest medical outpatient facility. A survey that consisted of sociodemography, socioeconomic, and health characteristics and the validated Short-Form Patient Satisfaction Questionnaire (PSQ-18) scale were used. Patient satisfaction was the highest in terms of service factors or tangible priorities, particularly “technical quality” and “accessibility and convenience,” but satisfaction was low in terms of service orientation of doctors, particularly the “time spent with doctor,” “interpersonal manners,” and “communication” during consultations. Gender, income level, and purpose of visit to the clinic were important correlates of patient satisfaction. Effort to improve service orientation among doctors through periodical professional development programs at hospital and national level is essential to boost the country's health service satisfaction.

Patient-reported outcomes of electrodessication and curettage for treatment of nonmelanoma skin cancer

We have shown that electrodessication and curettage (ED&C) cures most (>95%) basal cell and cutaneous squamous cell carcinomas (nonmelanoma skin cancers, NMSCs) for which it is used,(1) but skin-related quality of life after ED&C does not improve as much as after excision or Mohs surgery.(2) Our goal was to determine other patient-reported outcomes (PROs) after treatment of NMSC with ED&C. We studied all patients with primary NMSCs treated with ED&C, excision, or Mohs surgery in 1999–2000 at a university hospital or its affiliated Veterans Affairs clinic, and who responded to a survey before treatment. The final sample consisted of 149 patients treated with ED&C and 568 treated with excision or Mohs surgery. Three months after treatment, we used an adapted version of the Patient Satisfaction Questionnaire (PSQ-18) to measure satisfaction with care, including its technical quality, interpersonal manner, communication, financial aspects, time with clinician, and accessibility.(4) Responses vary from 1 to 5, with higher scores indicating greater satisfaction. One year after treatment, we used global items to measure patients’ description of cosmetic appearance, bother from appearance, bother from scar, judgment of treatment worth, and overall satisfaction with treatment. The response rate for PROs varied from 65% to 92%. We used the chi-squared test for categorical variables and the Wilcoxon rank sum test for continuous variables. We used multivariable logistic regression models to determine if treatment independently predicted PROs better or worse than the median; these models adjusted for patient characteristics (age, gender, number of tumors at enrollment), tumor characteristics (histological type, diameter, invasiveness, location on the head and neck), practice site, and clinician training level. Tumors treated with ED&C were less likely than those treated with excision or Mohs surgery to be located on the head and neck, to be invasive, to have histological risk factors for recurrence, and to have been treated by an attending physician (Table 1). Table 1 Characteristics of study sample of patients with nonmelanoma skin cancera Three months after treatment, both groups were similarly satisfied with all domains of care except that patients treated with ED&C were somewhat less satisfied with the time spent with the clinician and the accessibility and convenience of their care. A year after treatment, patients treated with ED&C described worse cosmetic appearance and were more bothered by the appearance (Table 2). In adjusted analyses, patients treated with ED&C remained twice as likely to report more frequent bother from appearance (p=.002), but did not differ in any other PRO. Table 2 Patient reported outcomes that differed in treatment groups after treatment of non-melanoma skin cancera,b Patients treated with ED&C for NMSC were as satisfied as those treated with excision or Mohs surgery with much of their care, but they were more frequently bothered by the appearance even in adjusted analyses that controlled for patient and tumor characteristics and training level of clinician. Interviews would be required to understand patients’ responses fully, but the results support the clinical impressions of many dermatologists: although overall outcomes are good, patients treated with ED&C may be more bothered by the treatment site. The findings highlight the importance of PROs after NMSC, and the need for thoughtful decision making for this most common cancer.

Self-Reported Financial Burden and Satisfaction With Care Among Patients With Cancer

Health care-related costs and satisfaction are compelling targets for quality improvement in cancer care delivery; however, little is known about how financial burden affects patient satisfaction. This was an observational, cross-sectional, survey-based study assessing patient-reported financial burden (FB). Eligible patients were ≥ 21 years with solid tumor malignancy and were receiving chemotherapy or hormonal therapy for ≥ 1 month. The Patient Satisfaction Questionnaire Short-Form assessed patient satisfaction with health care. Subjective FB related to cancer treatment was measured on a 5-point Likert scale. Of 174 participants (32% response rate), 47% reported significant/catastrophic FB. Participants reported highest satisfaction with interpersonal manner and lowest satisfaction with financial aspects of care. In adjusted analysis, high FB was negatively associated with general satisfaction (coefficient: -.29), satisfaction with technical quality (coefficient: -.26), and satisfaction with financial aspects of care (coefficient: -.62). Older age was associated with higher scores in all satisfaction subscales except patient-physician communication and financial aspects. Annual household income of <$20,000 was associated with lower satisfaction scores in all subscales except time spent with doctor. High FB was not associated with patient satisfaction scores for accessibility and convenience, communication, interpersonal manner, or time spent with doctor. FB is a potentially modifiable correlate of poor satisfaction with cancer care including general satisfaction and satisfaction with the technical quality of care. Addressing cancer-associated FB may lead to improved satisfaction, which in turn can influence adherence, outcomes, and quality of life.

A Study on Patient Satisfaction at a Multi Super Specialty Hospital in Delhi

The main objective of the study was to assess the level of satisfaction in terms of various quality dimensions among the patients in the study hospital. Data were collected from inpatients through structured questionnaire on eight quality dimensions such as general satisfaction, technical quality, interpersonal manner, communication, financial aspects, time spent with doctors, accessibility and convenience, and hospital services. In total, 100 inpatients were included from three departments with highest patient inflow: medicine, gynecology, and surgery. Most of the respondents were male and belongs to the age group of 31–45 years. Findings depict that highest level of satisfaction was found for interpersonal manner (86.3%) followed by communication (85.4%), general satisfaction (79.3%), and technical quality (77.3%). Least level of satisfaction was found for financial aspects (61.6%), followed by hospital services (68%), accessibility and convenience (73.5%), and time spent with doctor (76.9%).

Primary Care Provider and Imaging Technician Satisfaction with a Teledermatology Project in Rural Veterans Health Administration Clinics

Assessment of a multisite rural teledermatology project between 2009 and 2012 in four Pacific Northwest states that trained primary care providers and imaging technicians in state-of-the-art techniques of telemedicine. In 2012, we assessed provider and imaging technician acceptability and satisfaction with a 32-item survey instrument based on the Patient Satisfaction Questionnaire developed by Ware et al. (Eval Program Plann 1983;6:247-63) and modified for telemedicine by Kraai et al. (J Card Fail 2011;17:684-690). Survey questions covered eight satisfaction domains: interpersonal manner, technical quality, accessibility, finances, efficacy, continuity, physical environment, and availability. Overall, 71% of the primary care providers and 94% of the imaging technicians reported being satisfied or extremely satisfied with the teledermatology project. Most (95%) providers found the continuing education classes on dermatology diagnosis and treatment topics useful, and 86% reported teledermatology was a good addition to regular patient services. Most (97%) of the imaging technicians were satisfied with the ability of teledermatology to improve the description of dermatology conditions using images of the lesions or rashes, and 91% were satisfied with the convenience of teledermatology. Challenges reported by both providers and imaging technicians include an increase in workload due to more patient visits related to dermatology care and limited information technology support. Given the Veterans Health Administration's initiatives to promote accessible health care to underserved Veterans using telehealth, these findings can inform future program designs for teledermatology.

La Civilidad en las Castas Veladas del México Actual

This paper deals with the problem of the present patterns of living together of Mexicans, starting from the concept of Caste , managed during the Colonial times. In the New Spain, that concept meant ‘racial mixture’ and, with that meaning, the concept integrated two different semantic horizons: that of the mixture of races and that of the social stratum . During the Colonial times, the caste placed people in two different horizons, one based on somatic characteristics, and another, based on social hierarchy. Today, the Novohispanic meanings of the words ‘caste’ y ‘race’ are absent. The issue of the somatic differences has disappeared from the analysis of the identity of the Mexican, but those differences are still underlined as a sign of differences of economic, educative and cultural wealth, and, overall, as a sign of interpersonal manners, that is, as signs of differences of civility.

Relevant patient perceptions and experiences for evaluating quality of interaction with physiotherapists during outpatient rehabilitation: a qualitative study

ObjectiveTo identify elements of the physiotherapist–patient interaction considered by patients when they evaluate the quality of care in outpatient rehabilitation settings. DesignA qualitative study with nine focus groups, Two researchers conducted the focus groups, and a topic guide with predetermined questions was used. Each group discussion was audiotaped,, transcribed verbatim and analyzed thematically according to a modified grounded theory approach. SettingThree postacute ambulatory centers in Barcelona, Madrid and Seville (Spain). ParticipantsFifty-seven adults undergoing outpatient rehabilitation for musculoskeletal conditions/injuries. ResultsPatients based their evaluations of quality of care on their assessment of physiotherapists’ willingness to provide information and education, technical expertise and interpersonal manners (eg. respect, emotional support and sensitivity changes in the patient's status). Both positive and negative aspects of the physiotherapist–patient interaction emerged under all these themes, except for friendly and respectful communication. ConclusionThis study identified which elements of the physiotherapist–patient interaction are considered by patients when evaluating the quality of care in rehabilitation outpatient settings. Further research should work to develop self-report questionnaires about patients’ experiences of the physiotherapist–patient interaction in rehabilitation services to provide empirical and quantitative evidence.