Likelihood Of Satisfaction Research Articles

Factors Associated With Satisfaction With Diabetes Care Among Patients Attending Public Diabetic Clinics in Dar es Salaam, Tanzania: A Cross‐Sectional Study

ABSTRACTBackgroundDiabetes is a major public health problem worldwide, currently affecting more than 537 million people. The disease is associated with high morbidity and mortality rates. Modern diabetes care has evolved toward more patient‐centered approaches, emphasizing individualized treatment plans and targets. This study sought to assess the level of satisfaction with diabetes care and related factors among patients attending public diabetes clinics in Dar es Salaam, Tanzania.MethodsThis descriptive cross‐sectional study used a simple random sampling method to recruit 423 diabetic patients from May to October 2023. Data collection was conducted using a structured questionnaire administered by an interviewer. The collected data were coded and analyzed using Statistical Package for the Social Sciences (SPSS) version 25.ResultsThe mean (±SD) age of participants was 58.7 (±11.68) years. About half (51.1%) of participants reported being satisfied with the diabetes care provided, 26.2% were very satisfied, and 22.7% were dissatisfied. Participants who usually spend 1–3 h pursuing services at the facilities had 0.40 less odds of being dissatisfied with diabetes care offered at the clinics compared to those who spend more than 3 h on each attendance (adjusted odds ratio [adjusted OR] 0.40, 95% confidence interval [CI] 0.21–0.76, p = 0.005). For each one‐unit increase in the communication subscale score, the likelihood of satisfaction (as opposed to being very satisfied) increased (adjusted OR 1.23, 95% CI 1.09–1.38, p = 0.001). Each one‐unit increase in the accessibility subscale score increased the probability of satisfaction (adjusted OR 1.12, 95% CI 1.02–1.24, p = 0.023) and decreased the probability of dissatisfaction (adjusted OR 0.85, 95% CI 0.76–0.95, p = 0.004).ConclusionThese findings highlight the importance of effective communication and accessibility in improving patient satisfaction with diabetes care in public clinics. Health facilities and allied stakeholders should engage in continual capacity building among healthcare providers. Furthermore, other studies should be conducted at different levels of health facilities across the country to capture new insights on the satisfaction of homogenous sub‐groups of patients.

Defining Clinically Meaningful Thresholds for Patient-Reported Outcomes in Knee Arthroplasty.

For primary knee arthroplasties, clinically meaningful thresholds of patient-reported outcomes that associate with patient satisfaction have not been defined appropriately. In this retrospective study of 26,720 primary total knee replacements registered in the Dutch Arthroplasty Register (2016-2018), receiver operating curve analysis was used to define minimal clinically important changes (MCICs) and patient acceptable symptom states (PASSs) with the anchor satisfaction. Patient-reported outcome measures were pain, European Quality of Life 5 Dimensions, Knee disability and Osteoarthritis Outcome Score, and Oxford Knee Score (OKS). Independent analyses were performed for groups, which showed statistically significant interactions with the (change in) score to achieve satisfaction in logistic regression. In this cohort, 84.9% completed the anchor questions, of whom 71.3% with a satisfaction score ≥8. Good discriminative abilities (area under the receiving operator curve >0.8) for PASS were achieved by OKS ≥38.5, pain in activity ≤2.5, Knee disability and Osteoarthritis Outcome Score ≤33, and Quality of Life-Index ≥0.813. Discriminative abilities for MCIC were not good. If assessed per baseline tercile, discrimination improved (area under the receiving operator curve >0.8) and yielded different MCICs per preoperative tercile (preoperative OKS ≤19: MCIC ≥19.5; pre-OKS 20-27: MCIC ≥14.5; pre-OKS ≥28: MCIC ≥8.5). For MCIC, the tercile method produced an 11% improved accuracy compared to one threshold for every patient. For the PASS scores, tercile-specific did not improve the accuracy of predicting satisfaction. Demographics were not clinically relevant in determining thresholds. Estimating the likelihood of satisfaction with surgery is critical in shared decision-making. Patients with more preoperative symptom severity require larger changes to report satisfaction. Both in the clinic and in science, such differences must be considered when predictions of satisfaction are attempted.

936-P: Nutrition Experiences among Caregivers of Youth with Type 1 Diabetes

Many children with type 1 diabetes (T1D) do not meet nutritional guidelines. Little is known about how caregivers perceive the necessity of appointments with a dietitian (RD) or how satisfied they are with their nutrition care. To better understand caregiver nutrition experiences and perceptions, we surveyed 838 families of children <18 years old receiving T1D care at Boston Children’s Hospital (BCH). Of 184 (22%) responses, 159 with complete data were analyzed. Using multivariable logistic regression, we assessed factors associated with caregiver (1) perception of the necessity for annual nutrition visits; (2) satisfaction with nutrition care and (3) encouragement from a nurse or doctor to meet with an RD. Covariates included child’s age, diabetes duration, gender, race and ethnicity, and diabetes technology use. Age and diabetes duration were categorized as <13 and ≥ 13 years old and ≤ 3 and > 3 years, respectively. Among children in the analysis, 55% were ≥ 13 years old and 51% had T1D for ≤ 3 years. Over half (56.6%) of respondents considered it necessary to see a RD every year. Older age (aOR=2.06, 95% CI [1.01, 4.20]) and shorter disease duration (aOR=2.50, 95% CI [1.22, 5.12]) were associated with this perception. Less than half (47.8%) reported satisfaction with their nutrition care, with shorter disease duration associated with a higher likelihood of satisfaction (aOR=2.24, 95% CI [1.13, 4.42]). Only 61.4% of respondents reported encouragement from a nurse or doctor to meet with a RD. No demographic or clinical characteristics were associated with this finding. Our findings suggest that caregiver satisfaction with nutrition care and its perceived need for children with T1D may wane with longer disease duration. However, the perceived need for nutrition services is also higher in parents of teens. Future work should delineate strategies for engaging families in nutrition education that is more tailored to later stages of the T1D journey. In addition, there is a need for teen-focused T1D nutrition care curricula. Disclosure E. N. Gordon: None. B. S. Dykeman: None. K. Greco: None. E. Rhodes: Other Relationship; Self; AstraZeneca. K. Garvey: None.

Quality of Antenatal Care among Mothers Attending Antenatal Care and associated factors at Jimma Medical Center south west Ethiopia.

Background: Globally complications during pregnancy, childbirth and the post-natal period are the leading causes of death and disability among women of reproductive age. The causes of these deaths are mostly preventable through proper care during pregnancy. Despite adoption of these model by Ethiopia, there is low utilization of antenatal care and skilled personnel at delivery in addition to poor quality of antenatal care which result in high maternal and perinatal mortality rate. Objective: The main objective of this study was to assess quality of antenatal care among mothers attending antenatal care in Jimma University Medical center. Methods: Hospital based cross sectional study was conducted among 358 mothers attending antenatal care in Jimma University Medical center, from April 01/2018 to May 31/2018. Result: The study also showed that overall satisfaction of client was 58.1%. The likelihood of satisfaction from antenatal care service was higher among clients who started antenatal care visit before 16 weeks [AOR = 1.76 (95%CI =1.04-2.99)], routine investigation was done [AOR =6.1 (95% CI= 2.54-14.63)], respectful [AOR= 2.15 (95% CI= 1.18-3.9)], privacy was maintained [AOR=1.84 (95% CI=1.07-3.18)] and waiting time was less than 60 minute [AOR= 2.05 (95% CI= 1.28-3.29)]. Conclusion and recommendations: This study also showed that gestational age at start of antenatal, routine investigation done, respectful, privacy and waiting time were independent predictors of client satisfaction. To improve quality of antenatal care there is need to provide in-service training for health care providers to improve providers’ practices as well as on importance of greeting clients. Keyword: Quality antenatal, Jimma, Ethiopia

Impact of Organizational Leadership on Physician Burnout and Satisfaction

ObjectiveTo evaluate the impact of organizational leadership on the professional satisfaction and burnout of individual physicians working for a large health care organization. Participants and MethodsWe surveyed physicians and scientists working for a large health care organization in October 2013. Validated tools were used to assess burnout. Physicians also rated the leadership qualities of their immediate supervisor in 12 specific dimensions on a 5-point Likert scale. All supervisors were themselves physicians/scientists. A composite leadership score was calculated by summing scores for the 12 individual items (range, 12-60; higher scores indicate more effective leadership). ResultsOf the 3896 physicians surveyed, 2813 (72.2%) responded. Supervisor scores in each of the 12 leadership dimensions and composite leadership score strongly correlated with the burnout and satisfaction scores of individual physicians (all P<.001). On multivariate analysis adjusting for age, sex, duration of employment at Mayo Clinic, and specialty, each 1-point increase in composite leadership score was associated with a 3.3% decrease in the likelihood of burnout (P<.001) and a 9.0% increase in the likelihood of satisfaction (P<.001) of the physicians supervised. The mean composite leadership rating of each division/department chair (n=128) also correlated with the prevalence of burnout (correlation=–0.330; r2=0.11; P<.001) and satisfaction (correlation=0.684; r2=0.47; P<.001) at the division/department level. ConclusionThe leadership qualities of physician supervisors appear to impact the well-being and satisfaction of individual physicians working in health care organizations. These findings have important implications for the selection and training of physician leaders and provide new insights into organizational factors that affect physician well-being.

Disparities in residential environment and satisfaction among urban residents in Dalian, China

Rapid socio-economic development in China has increased social inequalities in various areas. So far, there has been considerable literature which studied objective residential disparities, but little research has investigated the differences in residents' satisfaction. Using large-scale 2006 residential survey data from Dalian, this paper examines the degree of disparities from three aspects: residential location, housing characteristics, as well as residential satisfaction. Results suggest that significant income-based disparities in residential environment do exist in Dalian. An investigation of the most vulnerable group yielded results consistent with existing knowledge of inequalities. It is shown that a higher ratio of low-income residents live in less livable neighborhoods and smaller housing space, while having a lower rate of homeownership and satisfaction than other groups. Further, the paper examines how housing reform in China influences residential disparities. Results indicate that low-income residents are faced with housing affordability problems under the market system as they have a lower ratio of owning commodity housing. However, the housing market provides them the much needed housing supply and choices, and is thus likely to increase their likelihood of satisfaction. For the high-income group, although their housing space increases greatly through the housing market, it may not outweigh the various locational and pricing advantages often associated with the past work unit housing. It is found that owning commodity housing has a lower probability of residential satisfaction for them. As home ownership does not necessarily improve the residential satisfaction level for low-income residents, it is suggested that adequate provisions of low-rent housing together with strict implementation of income criteria to be eligible for applying subsidized housing might be helpful to reduce residential disparities.

Postmastectomy Radiation Therapy and Breast Reconstruction: An Analysis of Complications and Patient Satisfaction.

Abstract Introduction: The indications for postmastectomy radiation therapy (PMRT) have expanded over the past decade. Plastic surgeons are reluctant to perform an immediate reconstruction followed by radiation because of their perception this sequence results in worse results. This study examines the relationship between the use and sequencing of radiation therapy on complication rates and patient satisfaction following reconstrucion.Methods: A retrospective chart review was performed of all women at an academic institution who underwent mastectomy and reconstruction from 1999-2006. The 769 reconstructed breasts were separated into 4 groups: PMRT prior to delayed reconstruction (n = 60); immediate reconstruction then PMRT (n = 56); reconstruction without PMRT (n = 540); and reconstruction after breast-conserving therapy with RT (BCT-RT, n = 113). The median length of follow-up was 44 months. All operative complications were categorized into early (≤90 days) or late. A questionnaire based on the Michigan Breast Reconstruction Outcomes Study assessed general and aesthetic satisfaction (response rate, 73.2%). Dichotomous variables were evaluated using the Fisher's exact or chi-squared test; statistical significance was set at p &amp;lt;0.05.Results: The overall complication rate for patients having PMRT (given before or after reconstruction) was higher than for patients with reconstruction only (36% vs. 27%, p = 0.048). The overall complication rate for women receiving PMRT then reconstruction was lower than for reconstruction then PMRT, although this was not statistically significant (28% vs. 45%, p = 0.068). Patients having reconstruction then PMRT had increased overall and late complication rates compared to patients having reconstruction only (45% vs.27.%, p = 0.006; 34% vs. 21%, p = 0.023, respectively). Results were similar when subdivided by the kind of reconstruction, except for increased late complications for patients having implant/expanders who had reconstruction then PMRT (62%, 8/13) compared to reconstruction alone (20%, 26/129) (p=0.003). General satisfaction was similar among all four groups. Aesthetic satisfaction was significantly lower in the PMRT then reconstruction group, compared to reconstruction only (48% vs. 65%, p = 0.029). Patients who underwent reconstruction then PMRT had similar aesthetic satisfaction compared to patients having reconstruction only (62% vs. 65%).Conclusions: Patients who have reconstruction prior to PMRT have increased overall and late complication rates compared to patients having reconstruction without radiation, but they have similar rates of general and aesthetic satisfaction. In contrast, patients who receive PMRT prior to delayed reconstruction have similar complication rates and general satisfaction levels to patients undergoing reconstruction only; however, the former patients report decreased aesthetic satisfaction. Patients requiring PMRT should consider both the risk of complications and likelihood of satisfaction in their decision-making process. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 4102.

Migraine treatment patterns and patient satisfaction with prior therapy: A substudy of a multicenter trial of rizatriptan effectiveness

Background: Migraine is a common, chronic, often disabling neurologic condition that is underdiagnosed and undertreated. Objective: We undertook this questionnaire-based study as a substudy of a multicenter trial of rizatriptan effectiveness. Our goal was to assess the history of acute migraine medication use and the relationship between different migraine medication regimens and patient satisfaction with prior therapy. Methods: This study was conducted at 85 neurology clinics throughout Spain from March Lo December 2001. It was planned prospectively as part of the screening visit for a multicenter trial of the effectiveness of rizatriptan therapy for migraine. Male and female patients ≥18 years of age were eligible for the primary trial, and hence for this study, if they had a history of migraine attacks and did not have a contraindication for triptan use. At the screening visit for the primary trial, a questionnaire was used by clinicians to record past and current use, and duration and order of use, of analgesics, nonsteroidal anti-inflammatory drugs (NSAIDs), ergot derivatives, and triptans; satisfaction with treatment was scored on a 5-point scale ranging from “very dissatisfied” to “very satisfied.” Results: Of 712 patients completing the questionnaire (mean [SD] age, 34 [10] years; range, 18–69 years), 75% were women and 94% experienced moderate or severe functional disability during migraine attacks. Analgesics were used by the majority of patients (81%) and for the longest mean [SD] duration (8.8 [7.6] years) but were associated with the least satisfaction (10% of patients “very satisfied” or “somewhat satisfied”). Triptans were used by the fewest patients (32%) and for the shortest mean duration (18 [1.6] years) but were associated with the highest rate of satisfaction (66%) compared with NSAIDs (27%) and ergot derivatives (31%). Regardless of duration or order of drug use, or sex or age of the patient, the likelihood of satisfaction with triptans was significantly greater ( P < 0.001) than with nontriptan regimens, with an adjusted odds ratio (95% CI) of 16.8 (11.4–24.9) versus analgesics, 5.1 (3.6–7.1) versus NSAIDs, and 4.1 (2.8–6.0) versus ergot derivatives. Conclusions: Our results showed that analgesics, NSAIDs, and ergot derivatives were used for long durations but provided low satisfaction among patients. Triptans were rarely used as a first treatment choice; however, patients reported the highest treatment satisfaction scores after triptan therapy compared with ergot derivatives, NSAIDs, or analgesics.

Factors associated with patient satisfaction with care among dermatological outpatients.

It has been shown that poor patient satisfaction can lead to poor adherence to treatment with consequently poor health outcomes. In order to improve the quality of care perceived by the patient and thus the health outcome, it is important to understand which are the main factors influencing patient satisfaction. To examine factors associated with patient satisfaction with care among dermatological out-patients. This longitudinal study is based on a sample of dermatology out-patients. The independent effects on patient's satisfaction of patient characteristics (sociodemographic characteristics, disease severity, quality of life) and of specific aspects of provided health care (the time the physician spent with patients, physician's interpersonal skills, etc.) were examined by multiple logistic regression. A total of 1389 out-patients were selected at random and invited to participate. Of the 722 patients who agreed to participate, 424 fulfilled the inclusion criteria and 396 of these patients (93.4%) completed the study. Overall satisfaction was reported by 60.0% of patients. The likelihood of overall satisfaction was found to be significantly and independently increased by the physician's ability to give explanations and to show empathy for the patient's condition, and by the older age of patients. The likelihood of satisfaction also increased with increasing disease severity, but decreased with symptom-related poor quality of life. The lowest level of satisfaction was found among patients whose symptom-related quality of life was worse than the clinical severity rated by the dermatologist. Improving the physician's interpersonal skills can increase patient satisfaction, which is likely to have a positive effect on treatment adherence and health outcomes. Dermatologists succeeded better in establishing a good relationship with clinically more severely affected patients than with patients who were clinically mildly affected despite their quality of life being impaired. Thus, the inclusion of a patient-rated quality of life can be a useful measure in dermatology, as it enables clinicians to perceive the patients' perception of their health status.