Measure Client Satisfaction Research Articles

Measuring Client Satisfaction in Residential Aged Care Settings: A Narrative Review of Instruments

Background: The aim of this paper is to provide a narrative review of validated instruments measuring client satisfaction in residential aged care facilities, including key attributes of the identified instruments. Methods: A systematic literature search was conducted using scientific journal databases (Medline, ProQuest Health and Medical, ProQuest Social Science and CINAHL), specialist journals and websites, and Google. The search was limited to peer-reviewed and research or instrument development articles published between January 1990 and November 2009. �Snowballingand hand searching of the references of the selected articles were also used to ensure all relevant articles were examined.Results: Ten instruments were identified as relevant for the in-depth review. The review suggested instrument development to date has tended to include the development of new domains, many of which broadly draw on the literature but are honed to the specific objectives of the study or the organization being evaluated. This has led to a diverse range of domains with broadly congruent characteristics but often with different nomenclature. Seven domains were thematically identified based on the most commonly captured aspects of the satisfaction measures reviewed; Interpersonal manner of the provider, Technical quality of care providers, Physical environment, Meals/dining, Socializing opportunities/activities/relationships with others, Spiritual services, and Organization/policy/administration. Conclusion: Further work is required to develop an instrument which addresses the gap caused by the inherently different goals of the service provider, staff and the individual client, and the differences which exist among individual clients. To assess truly person-centered approaches of care, satisfaction instruments should reflect individual clients perceived importance and expectation on different domains of care/services.

REFOCUS Trial: protocol for a cluster randomised controlled trial of a pro-recovery intervention within community based mental health teams.

BackgroundThere is a consensus about the importance of 'recovery' in mental health services, but the evidence base is limited.Methods/DesignA two centre, cluster randomised controlled trial. Participants are community-based mental health teams, and service users aged 18-65 years with a primary clinical diagnosis of psychosis. In relation to the REFOCUS Manual researchintorecovery.com/refocus, which describes a 12-month, pro-recovery intervention based on the REFOCUS Model, the objectives are: (1) To establish the effectiveness of the intervention described in the REFOCUS Manual; (2) To validate the REFOCUS Model; (3) To establish and optimise trial parameters for the REFOCUS Manual; and (4) To understand the relationship between clinical outcomes and recovery outcomes. The hypothesis for the main study is that service users in the intervention arm will experience significantly greater increases in measures of personal recovery (as measured by the QPR) compared to service users receiving care from control teams. The hypothesis for the secondary study is that black service users in the intervention arm will experience significantly greater increases in measures of personal recovery (as measured by the QPR) and client satisfaction (as measured by the CSQ) compared to Black service users receiving care from control teams.The intervention comprises treatment as usual plus two components: recovery-promoting relationships and working practices. The control condition is treatment as usual. The primary outcme is the Process of Recovery Questionnaire (QPR). Secondary outcomes are satisfaction, Goal setting - Personal Primary Outcome, hope, well-being, empowerment, and quality of life. Primary outcomes for the secondary study will be QPR and satisfaction. Cost data will be estimated, and clinical outcomes will also be reported (symptomatology, need, social disability, functioning).29 teams (15 intervention and 14 control) will be randomised. Within each team, 15 services users will be randomly chosen, giving a total sample of 435 service users (225 in intervention and 210 in control). Power for the main study: 336 service users will give power to detect a medium effect size of 0.4 (alpha 0.05, power = 0.8) on both QPR sub-scales. Power for the secondary study: 89 participants will give power to detect an effect size of 0.67 on both QPR sub-scales and on CSQ. A range of approaches are used to minimise bias, although service users and clinicians cannot be blinded.DiscussionThis cluster-RCT will evaluate a pro-recovery intervention in community mental health teams.Trial registrationISRCTN: ISRCTN02507940

Incorporating Perceived Importance of Service Elements Into Client Satisfaction Measures

Objective: The purpose of this study was to assess the need for incorporating perceived importance of service elements into client satisfaction measures. Method: A secondary analysis of client satisfaction data from 112 clients of an elderly case management setting was conducted. Results: This study found that the relationship between global client satisfaction and the composite of satisfaction with service elements differed significantly, depending on perceived importance of service elements. Conclusions: These results call into question the practice of simply adding or averaging scores from satisfaction items to produce global satisfaction scores without considering perceived importance of the service elements.

Evaluating Sorensen’s Therapy for Instability in Mood (STIM) in the case of bipolar disorder

This study’s aims were to evaluate the effects of Sorensen’s Therapy of Instability in Mood (Sorensen, 2005; Sorensen, Done & Rhodes, 2007), an intervention based on a short relapse-prevention program for clients suffering from Bipolar Disorder (BD), delivered within a clinical setting, by an assistant psychologist with limited training in CBT. The experimental treatment consisted of four individual sessions in addition to treatment as usual. Twelve clients with diagnoses of BD participated. Outcomes were measured across four domains: symptom severity, perceived hopelessness, perceived control over symptoms and level of insight. Measures of client satisfaction were also collected. Statistical analysis of the data revealed significant improvements to depression and perceived control levels at both one and three month follow-ups. In addition, clients reported significantly lower levels of hopelessness at three months follow-up. The study also considered the clinical significance of the research findings with the Jacobson-Truax (Jacobson & Truax, 1991) method. A substantial number of clients attained clinically significant changes with regards to depression, hopelessness and perceived control at one and three months follow-ups. Recovery rates at three months were 50%, 41.6% and 25% respectively. Neither statistically nor clinically significant changes were found with regards to mania or insight at either one or three month follow-ups. All clients reported high levels of satisfaction.

Implementing the Illness Management and Recovery Program in Japan

Implementing the Illness Management and Recovery Program in Japan

The effects of meeting a family therapy supervision team on client satisfaction in an initial session

Despite the wide use of live supervision in marriage and family therapy training, there have been no randomized trials comparing different variations of the practice. This randomized trial of 86 clients was designed to measure client satisfaction after an initial therapy session under two conditions: meeting the supervision team behind the observation mirror or not meeting the team. A mixed linear model analysis of covariance was used to examine the relationship between ‘meeting the team’ versus ‘not meeting the team’ and client satisfaction. There were no statistically significant differences in client satisfaction based on whether clients met the team or not. There was a trend toward greater satisfaction with the therapy session among clients who did not meet the supervision team.

Measuring Client Satisfaction with Child Welfare Services

This article examines the role of client satisfaction indicators in child welfare agency performance measurement. It examines both research and performance measurement efforts to understand client perspectives on child protection and out-of-home care services. It highlights the value of obtaining data from clients about their experience of the service delivered by the agency and its impact on their lives. Conceptual, methodological and ethical issues in implementing routine, standardized data collection on client satisfaction are discussed. Measuring client satisfaction within a suite of performance indicators is an example of how practitioners and managers can use one of the tools of managerialism in the interests of clients and good practice.

Development and validation of an instrument for measuring appointment-specific client satisfaction in companion-animal practice

Healthcare research recognizes that ‘satisfaction’ is an important health outcome of the medical encounter. As a result, many healthcare professions have pursued the development and validation of instruments for measuring patient satisfaction. However, veterinary medicine has developed and properly validated few instruments for measuring client satisfaction. This paper describes the development and psychometric assessment of an instrument for measuring appointment-specific client satisfaction in companion-animal practice. We developed the Client Satisfaction Questionnaire (CSQ) in four main phases. Phase I relied on a series of six pet-owner focus groups ( n = 32) to explore clients’ expectations of veterinary care to provide a basis for constructing items for the CSQ. Phase II involved developing items for a first draft of the CSQ, using the content and themes taken from the pet-owner focus groups. In phase III we pre-tested the first draft with six veterinarians in companion-animal practice and a convenience sample of their clients ( n = 129). Data from the pre-test were used to test the initial psychometric characteristics of each item. Together with participant feedback, these findings were used to design the final, 15-item CSQ. Phase IV involved psychometrically testing the final, 15-item CSQ as part of a larger observational study involving 20 veterinarians and 344 of their clients. We used data from this sample to assess the reliability and validity of the CSQ in companion-animal practice. Assessment was based on descriptive statistics, principal-component analysis, generalizability theory and linear mixed modeling. Findings demonstrate excellent reliability ( G-coefficient for internal consistency = 0.96) and support the face, content and construct validity of the CSQ as a measure of appointment-specific client satisfaction in companion-animal practice.

How to Measure Client Satisfaction With Stop Smoking Services: A Pilot Project in the UK National Health Service

AbstractThis pilot study aimed to develop a tool and methodology for measuring client satisfaction in UK National Health (NHS) Stop Smoking Services (SSS). A brief postcard questionnaire (measuring overall satisfaction with the service, willingness to recommend the service to others and smoking status) and a complete questionnaire (with 20 additional items measuring satisfaction with specific elements of the service) were developed. An NHS SSS mailed the postcard to 298 clients who had set a quit date in the previous quarter, they mailed the complete questionnaire to a subsample of 99 clients. Overall 34% (100/298) of those surveyed responded: 30% (90/298) for the card and 25% (25/99) for the questionnaire (15 people responded to both). Intraclass correlation coefficients (ICC) were found to be acceptable for both the overall service satisfaction item (ICC value = .43, p = .05) and the item regarding recommending the service to others (ICC-value = .83, p < .001). Hence the tool had reliability and at least face validity and the survey methodology proved practicable. The small modifications made to service delivery and the need for future research are discussed.

An effectiveness trial of cognitive behaviour therapy in a representative sample of outpatients with psychosis

The efficacy of cognitive behaviour therapies for psychosis (CBTp) has been sufficiently established for its inclusion in some national treatment guidelines. However, treatment efficacy does not guarantee effectiveness in routine practice, where clinician expertise and patient mix may be different. Thus, we evaluated the applicability, acceptability and effectiveness of CBTp when offered routinely in a public mental health service. A prospectively recruited representative sample (N=94) of patients with psychotic disorders from a geographic catchment area in Melbourne, Australia, was randomized to CBTp or treatment as usual. The CBTp intervention included psychoeducation, positive symptom, and co-morbid problem components. Therapists collaboratively negotiated goals with patients and utilized treatment components from a manual. Intention-to-treat analyses used data at baseline, 9 months and 18 months. Working alliance and client satisfaction measures indicated excellent acceptability. Both groups improved to a similar degree on the Positive And Negative Syndrome Scale, with no advantage for the CBTp group. The most frequent CBTp components implemented were co-morbid disorders/personal issues and personalized psychoeducation; working with persisting symptoms was the main focus in relatively few sessions. The lack of advantage for the CBTp group may be due to: the infrequent focus on positive symptoms (the most replicated outcome domain for CBTp); the unselected nature of the patients (rather than those with distressing symptoms or referred by clinicians); or, to insufficient therapist expertise.

Importance Counts: The Role of Relative Importance of Service Elements in Client Satisfaction Measures

ABSTRACTIt is not uncommon for social work service providers, researchers, and evaluators to develop measures to obtain client satisfaction data relevant to their particular service settings. These measures are often constructed through a set of (usually Likert-type) satisfaction rating response items for each of the service elements relevant to their settings. Scores from these multiple items are then either summed or averaged to produce global satisfaction scores. By summing or averaging satisfaction scores across all items, one implicitly assumes that all survey items that represent various service elements carry equal weight. This assumption of equal weight is somewhat counterintuitive because individual clients may perceive certain survey items or service elements to be more important, or carry more weight, than others. Analyzing data from interviews with 112 clients of an elderly case management service agency in a large city in the Midwest region of the United States, this study examined this equal weight assumption in an elderly case management service setting. Results indicated that not all service elements were considered equally important, which called into question the common practice of summing or averaging satisfaction scores of various service elements to represent global client satisfaction.

What does client satisfaction tell us about effectiveness?

AbstractIt is common in child protection research to undertake studies of client satisfaction with services. Although these studies have their own intrinsic value, it has been argued that they tell us little if anything about effectiveness—high levels of client satisfaction mean little if child abuse continues to occur. This study, undertaken in a statutory child protection service in Australia, considers the relationship between client satisfaction and other outcome measures, including worker estimates of client progress, further notifications of abuse and whether or not children have been removed. The results show strong correlations between different measures of client satisfaction and strong correlations between different measures of worker estimates of client progress. They show weaker but statistically significant correlations between client satisfaction and worker estimates of client progress, and between client satisfaction and further notifications. There is also a significant relationship between client satisfaction and children remaining at home. However, this applies only to parents, relatives and carers, not to the primary clients themselves. It is concluded that client satisfaction studies may have value beyond simply measuring client satisfaction. However, the study also supports an argument for using more than one outcome measure if the aim is to measure effectiveness. Copyright © 2008 John Wiley & Sons, Ltd.

The cataract service satisfaction tool

PurposeClient satisfaction is an important outcome measure of healthcare services. The aims of the present work are to develop a tool to assess client satisfaction with the components of streamlined cataract services and to conduct a pilot study to evaluate its reliability and validity.Design/methodology/approachA validated patient satisfaction questionnaire was modified for use in a cataract service and validated by expert panel and patient focus group approach. Two versions were used to evaluate pre‐operative assessment clinic and day surgical unit. The questionnaires comprised items covering individual domains of client satisfaction plus one global satisfaction item. Together with a visual analogue scale (VAS) the questionnaires were administered to 200 consecutive cataract patients.FindingsThe questionnaires were returned by 165 patients (82.5 per cent). Median individual item and global scores in the pre‐operative group were 87 and 100 per cent, respectively. In the day‐of‐surgery group median scores were 91 and 100 per cent, respectively. Mean VAS scores were 95.5 per cent (SD 5.6) and 94.5 per cent (SD 6.4), respectively. Cronbach's alpha was 0.768 for the pre‐operative and 0.636 for the day‐of‐surgery questionnaire. Spearman's correlation coefficient between individual item score and the VAS score was 0.350 (p=0.005) for the pre‐operative and 0.302 (p=0.028) for the day‐of‐surgery questionnaire. Spearman's correlation coefficient between individual item score and the global satisfaction score was 0.566 (p<0.001) for the pre‐operative and 0.317 (p=0.004) for the day‐of‐surgery questionnaire.Originality/valueThe questionnaire appears to be a useful tool for measuring client satisfaction with a one‐stop cataract pre‐assessment service where surgery is performed at a second visit, which other cataract service providers might adapt for local use.

“It's much easier than going to the dentist”: high levels of satisfaction in a mammography screening program

To develop a suitable instrument for measuring client satisfaction in the BreastScreen New South Wales (NSW) program and to use the instrument to measure client satisfaction. The survey was designed and administered to 2,091 women who attended mammography screening in the BreastScreen NSW program during 2001 (85% response rate). The survey evaluated experiences of making appointments, the screening environment, the screening procedure, and the receipt of results. Socio-demographic differentials in client satisfaction were examined using logistic regression models. The majority of women were highly satisfied with their experience, with transport/parking, breast discomfort and time to results causing the most dissatisfaction (8-9%). The main source of dissatisfaction was during the appointment and related to discomfort during the mammogram (9%) and breast problems following the mammogram (9%). Predictors of dissatisfaction with screening (p<0.05) included high education level (OR=1.4), non-Australian born (OR=1.4), and aged 40-49 years (OR=1.6). Although overall satisfaction was high, the survey indicated service functions where improvements could be made. This research has developed an appropriate tool for assessing and monitoring client satisfaction with breast screening services.

Case management for the mentally ill: a comparative evaluation of client satisfaction

This paper reports on client satisfaction with community mental health services. A Client Satisfaction Interview was used as one outcome measure in a randomized controlled study of clinical case management vs. standard community care. The Interview had high internal consistency reliability (Cronbach's alpha = 0.89) with very high inter-rater reliability for overall scores (r= 0.99) and good inter-rater reliability for individual items (kappa over 0.9 for 18 of 22 items). Case management clients had significantly higher total satisfaction scores than control group clients who received standard community care at 9 months (t= 2.02 P= 0.05) but not at baseline (t= 0.59, P= 0.55) or 18 months (t= 1.76, P= 0.09). In addition to a quantitative measure of satisfaction, clients were asked to provide more qualitative accounts of their experience with services. The findings are discussed in relation to the team's model of case management and the differences between case management and control services. The limitations of this study are considered in the context of methodological issues surrounding measurement of client satisfaction and the study's own methodological shortcomings.

Using Client Satisfaction to Improve Case Management Services for the Elderly

Although client satisfaction has long been an important form of program evaluation, one of the major limitations regarding client satisfaction studies has been the inability to provide concrete feedback for service providers. This study describes the use of a client-centered approach to developing a client satisfaction measure for a case management setting, Client Satisfaction: Case Management (CSAT-CM). The CSAT-CM overcomes major limitations associated with prior client satisfaction studies and can be used to collect client satisfaction data that will provide concrete feedback for the service providers to improve their case management services. Preliminary results indicate that CSAT-CM has desirable psychometric properties. The proposed practical method of measuring client satisfaction has the potential to be adapted by other types of social service agencies.

Acceptability as a key determinant of client satisfaction: lessons from an evaluation of adolescent friendly health services in Mongolia

Purpose The primary focus of this study is to investigate which characteristics of health service quality are most likely to determine client satisfaction with health services among adolescents in Mongolia. Methods Data were gathered from 1301 male and female clients. Exit interviews were used to measure client satisfaction; 82 clinics were visited. All clients between the ages of 10 and 19 years were asked to participate in the client exit interview; those who agreed to participate completed the questionnaire. Bivariate and multivariate analyses were conducted to determine significant associations between service satisfaction and the independent variables. All variables showing a significant bivariate association with service satisfaction ( p ≤ .05) were retained for logistic regression analyses. Results The strongest determinant to client satisfaction related to acceptability: adequate facility physical environment, receiving adequate information about the facility, and if the facility was private (i.e., other people didn’t know the services the client received). Additionally, clients who said they received some interruptions, either by other health workers or clients, were significantly less likely to be satisfied with the services. Conclusions This study demonstrates the importance of understanding and measuring different aspects of health service quality in defining client satisfaction. Although both accessibility and acceptability of services have been shown to be important in other studies, characteristics relating to acceptability emerged as critical in determining client satisfaction among adolescents in Mongolia. Efforts to improve health service delivery to adolescents need to understand and address the “adolescent friendly” characteristics that are most salient, and least fulfilled, in each particular context.

Consumer involvement in consent document development: a multicenter cluster randomized trial to assess study participants' understanding

Despite widespread agreement on the importance of informed consent in clinical research, uncertainty remains about the adequacy of current consent procedures and documentation. The objective of the study was to compare an informed consent document developed by a consumer group of potential study participants to one developed by the study investigators. The study was a cluster randomized, controlled study embedded in a 'parent' randomized controlled trial of 1092 participants with Gulf War veterans' illnesses recruited in 1999-2000 at 20 US medical centers. Centers were randomized to the investigator-developed or participant-developed consent document. The primary outcome measure was an Informed Consent Questionnaire-4 (ICQ-4), a validated four-item scale measuring self-reported participant understanding scored from 0 to 1. Secondary outcomes included the Client Satisfaction Questionnaire-8 and measures of study refusal and adherence to the parent trial protocol. There were no significant differences between consent documents on the ICQ-4 score overall or at any of the time points. Mean (95% CI) treatment differences ranged from +0.020 (-0.015, 0.055) (better understanding) at entry to -0.021 (-0.054, 0.012) (worse understanding) at three-months for the participant versus the investigator document group. There were also no significant differences in satisfaction, adherence to the protocol, or in the proportion of patients who refused to participate in the trial. The consumer group may not have been representative of the study participants and they did not suggest dramatic changes to the consent document. The outcome assessment questionnaire was not validated prior to the trial's initiation. Consumer modification of the consent document did not lead to either benefit or harm in understanding, satisfaction, or study refusal and adherence rates. This study did demonstrate, however, that embedding consent studies in a clinical trial is feasible and can address important questions about informed consent without disrupting the primary study.

Caught in the web of quality

This study investigates the quality assurance of web-supported learning and may be considered a self-evaluation exercise of the e-learning design and production unit at the University of Pretoria, South Africa. While the ‘quality’ discourse and the ‘e-learning’ discourse are topical, there is little evidence of research projects which attempt to diminish the gap between them (Reid, 2003). The theoretical framework on which this study is based is that of an integrated, process-based quality management system, applied to web-supported processes and products. The paper is presented in three parts, namely the methodology of the quality management system, critical success factors for web-supported learning, and a student feedback survey measuring client satisfaction.

AN EXPLORATION OF THE THERAPEUTIC RELATIONSHIP AND COUNSELLING OUTCOMES IN A PROBLEM GAMBLING COUNSELLING SERVICE

This study examined the relationship between a number of counselling process variables thought to influence counselling outcomes in a sample of 150 clients undertaking short‐term counselling in the state‐wide government funded Gambler's Help problem gambling counselling services in Victoria, Australia. Factors measured included psychosocial well‐being of clients prior to and after counselling, client readiness to change, self‐reported gambling activity levels before and after counselling, self‐assessment of current gambling behaviour, strength of therapeutic alliance, self‐reported counselling outcomes achieved in the area of symptoms, life matters, and related problems and a measure of client satisfaction with the service. The therapeutic alliance was found to have the strongest predictive power with respect to the level of problem resolution achieved by clients across all but one of the problem areas. The implications of these findings for clinical social work practice and education of practitioners are noted.