Medical Satisfaction Research Articles

Exploring the Application of a Multi-Targeted Nursing Group for Enhanced Recovery After Surgery Using the LEER ("Less Pain", "Early Movement", "Early Return to a Normal Diet" and "Reassurance") Model.

ObjectiveTo explore the effects and value of establishing a multi-target nursing group (MTNG) for facilitating goal-oriented enhanced recovery after surgery (ERAS) using the LEER (“less pain”, “early movement”, “early return to a normal diet” and “reassurance”) model.MethodsThe clinical data of 198 patients with hepatobiliary and pancreatic malignancies were retrospectively analyzed. The patients were divided into two groups: 91 cases were collected in a traditional group, which adopted traditional perioperative care, and 107 cases were collected in an MTNG group, which adopted MTNG measures. The differences in the clinical data including postoperative recovery, unplanned readmission rate, the implementation rate of nursing measures, the degree of a patient’s understanding of the disease, and patient compliance and satisfaction with nursing care during hospitalization were compared and analyzed between the two groups.ResultsThe MTNG group reflected a lower pain degree and hospitalization expenses (P < 0.05), earlier postoperative flatulence, earlier recommencing of a normal diet, and earlier postoperative ambulation (P < 0.05), together with a shorter postoperative indwelling catheter duration and length of hospital stay (P < 0.05). There were no significant differences in the incidence of postoperative complications and unplanned postoperative readmission rates between the two groups (P > 0.05). The implementation rate of nursing measures and the degree of patients understanding the disease, and patient compliance and satisfaction with nursing care were higher in the MTNG group (P < 0.05).ConclusionThe MTNG approach, based on ERAS with the LEER model, was conducive to the safe and rapid postoperative recovery of patients, the precise and efficient implementation of ERAS measures, the improvement of medical treatment satisfaction among patients.

E-Learning during COVID-19 pandemic; Turning a crisis into opportunity: A cross-sectional study at The University of Jordan

ObjectivesTo assess the medical students' satisfaction and knowledge attainment through distant learning during the COVID-19 pandemic. MethodsThis is a cross-sectional, self-reported, questionnaire-based study that was conducted at the School of Medicine at the University of Jordan in April 2020. The targeted population was the students at the school of medicine. An online questionnaire was created using Google Forms. Satisfaction and knowledge attainment among students were assessed using independent-samples t-test. ResultsA total of 1000 medical students completed the survey, 506 (50.6%) basic science students and 494 (49.4%) were clinical science students. 655 (65.5%) of all students were either satisfied or neutral with e-learning. 63.6% of basic science students and 59.5% of clinical students stated that they gained and understood knowledge in the same way as or better than they did before initiation of exclusive e-learning. Satisfaction and knowledge gain were significantly affected by student preparedness (p < 0.000), teacher performance (p < 0.000), and website accessibility (p < 0.000). ConclusionTransition from traditional in-class teaching to distant learning, whether full or blended, is an inevitable step. In our sample, students were generally satisfied with e-learning and the knowledge attained using it. There was a significant relation between satisfaction and attainment and preparedness of students, teachers, and the medical school.

The Policy Effect of China’s Medical and Health System Reform：Based on the Investigation of Pilot Comprehensive Medical Reform

Comprehensive medical reform is important to explore the medical and health system reform. It is the main direction of deepening medical reform, which is a powerful driving force for building a healthy China. This paper uses the data of the China Family Panel Studies （CFPS） 2010, 2012, 2014 and 2018, and treats the provinces in the pilot comprehensive medical reform as the treatment group and the remaining provinces as the control group. The DID method is used to examine the impact of comprehensive health care reform on residents’ medical treatment satisfaction, medical level acceptance and medical expenditures.Firstly, this paper cuts from the two perspectives of residents’ medical treatment satisfaction and medical level acceptance. It is more authentic and purposeful to investigate from the individual’s intuitive perception of medical conditions and medical services. Secondly, this paper cuts from the perspective of medical expenditures, and examines the annual medical expenditures of residents （absolute medical expenditures）, annual medical expenditures excluding reimbursements （absolute out-of-pocket medical expenditures）, the ratio of medical expenditures to family expenditures （relative medical expenditures）, the ratio of out-of-pocket medical expenditures to family expenditures （relative out-of-pocket medical expenditures）, and the ratio of out-of-pocket medical expenditures to medical expenditures （the ratio of out-of-pocket expenditures）, among which residents’ personal medical expenditures include hospitalization expenditures and injury and illness expenditures （non-hospital expenditures）.It is found that the comprehensive medical reform has significantly increased residents’ medical treatment satisfaction and medical level acceptance. Although the comprehensive medical reform fails to reduce residents’ absolute medical expenditures and absolute out-of-pocket medical expenditures, it significantly reduces relative medical expenditures and relative out-of-pocket medical expenditures. Further research finds that the comprehensive medical reform mainly reduces hospitalization expenditures, but it fails to reduce injury and illness expenditures in medical expenditures; from the perspective of self-paid ratio, the comprehensive medical reform significantly reduces the proportion of residents’ out-of-pocket expenditures; compared with rural areas, the policy effect of comprehensive medical reform in urban areas is more obvious. In general, the comprehensive medical reform has significant policy effects in many aspects, which has relatively reduced the burden of residents’ medical expenditures, but it has failed to directly reduce residents’ medical expenditures.

Relationship between Consulting for Second Medical Opinions, Radiotherapy, and Satisfaction with Therapy, Analyzed by Structural Equation Modeling: A Web-Based Survey.

Objective:The radiotherapy utilization rate in Japan is lower than that in other developed countries. This study identified factors associated with the low rate, by conducting an online survey of Japanese cancer survivors. Methods:We reviewed the web survey results of Japanese cancer patients. The survey examined the process of choosing treatments and the actual treatment received. We included respondents whose most engaged-in treatment was either radiotherapy or surgery, dividing them into two groups. We used the chi-square test to compare the patients in the both groups for their impression of the therapy, decision-making approach, and decision to seek second medical opinions (SMOs). To assess the relationship between seeking SMOs, being most engaged in radiotherapy, and feeling satisfied, we used the structural equation modeling (SEM) approach. Results:We included 139 patients in the radiotherapy group and 681 patients in the surgery group. Compared with patients in the surgery group, more patients in the radiotherapy group sought SMOs (19% vs. 28%), shared opinions with their doctor (27% vs. 42%), and were satisfied with their treatment (69% vs. 78%). SEM analysis showed that seeking SMOs contributed to radiotherapy being the most-engaged-in therapy (β = 0.23; P < 0.01), and the treatment contributed to the satisfaction (β = 0.15; P < 0.01). Conclusion:Patients who underwent radiotherapy felt more satisfied with the treatment than patients who underwent surgery. Perceptions about radiotherapy and SMOs may be a reason for the low utilization of radiotherapy in Japan.

Evaluation of the Medical Students' Satisfaction with Learning About Diabetes Through the Mobile App During the COVID-19 Pandemic

Background: The use of technology in distance education can help cross the borders of space and time for lifelong learning. One of the active learning methods is the use of the mobile apps with the potential to develop medical education. Objectives: The aim of this study was to evaluate the efficacy of using diabetes educational mobile app in the endocrine physiology virtual classroom during the COVID-19 pandemic. Methods: In the present study, an educational mobile app for diabetes, including the information modules, as well as educational videos made by the researchers of this study, was designed for 32 medical students of Abadan University of Medical Sciences who had endocrine physiology courses in the first semester of the academic year 2019 - 2021. A researcher-made questionnaire consisting of 10 questions about learning the educational content of diabetes through the application containing educational videos in the virtual classroom of endocrine physiology, scoring based on a five-point Likert scale, was provided. The data were analyzed by SPSS 21 using descriptive statistics. Results: The results obtained based on the highest satisfaction percentage were as follows: creativity in learning (90.625%), fast learning (87.5%), accessible learning (84.375%), practical learning (81.25%), sustainable learning (81.25%), eagerness to learn (78.78%), attractive learning (78.125%), accurate learning (78.125%), reducing the student's dependence on the teacher (75%), and feeling more confident (75%). Conclusions: Using educational applications along with other teaching methods can lead to fast, creative, practical, accurate, and lasting learning, and due to its attractiveness, it creates a desire to learn in people.

Outcomes of Remote Patient Monitoring for Automated Peritoneal Dialysis: A Randomized Controlled Trial

Introduction: We hypothesize that remote patient monitoring (RPM) for automated peritoneal dialysis (APD) and feedback could enhance patient self-management and improve outcomes. The aim of this study was to evaluate the efficacy of RPM-APD compared to traditional APD (T-APD) without RPM. Methods: In this multicenter, randomized controlled trial, patients on APD were randomized to T-APD (n = 29) or RPM-APD (n = 28) at 12 weeks and followed until 25 weeks. Health-related quality of life (HRQOL), patient and medical staff satisfaction with RPM-APD, and dialysis-related outcomes were compared between the 2 groups. Results: We found no significant differences in HRQOL scores at the time of enrollment and randomization between RPM-APD and T-APD. At the end of the study, the RPM-APD group showed better HRQOL for the sleep domain (p = 0.049) than the T-APD group and the T-APD group showed better HRQOL for the sexual function domain (p = 0.030) than the RPM-APD group. However, we found no significant interactions between the time and groups in terms of HRQOL. Different HRQOL domains significantly improved over time in patients undergoing RPM-APD (effects of kidney disease, p = 0.025) and T-APD (burden of kidney disease, p = 0.029; physical component summary, p = 0.048). Though medical staff satisfaction with RPM-APD was neutral, most patients were quite satisfied with RPM-APD (median score 82; possible total score 105 on 21 5-item scales) and the rating scores were maintained during the study period. We found no significant differences in dialysis adherence, accuracy, adequacy, overhydration status, blood pressure, or the number of unplanned visits between the 2 groups. Discussion/Conclusion: Although HRQOL and dialysis-related outcomes were comparable between RPM-APD and T-APD, RPM-APD was positive in terms of patient satisfaction. Further long-term and large-scale studies will be required to determine the efficacy of RPM-APD. Trial Registration: CRIS identifier: KCT0003390, registered on December 14, 2018 – retrospectively registered, https://cris.nih.go.kr/cris/search/search_result_st01.jsp?seq=12348.

Evaluating medical travelers’ satisfaction through online review analysis

Medical tourism is increasing quickly since it contributes to both the health and tourism sectors. The use of big social data has been effective in the development of medical tourism as a huge amount of data is produced and shared by travelers about the services through different social media platforms. Indeed, communicative information and knowledge can be mined from a large amount of information provided by travelers about medical tourism services. It is important to analyze such data to understand the customers' satisfaction level and their demands. Although several studies have been conducted to find the factors influencing customer satisfaction in medical tourism, there is a lack of studies about big social data and online behavioral analysis of medical travelers. In addition, the analysis of customers' online reviews is fairly unexplored by machine learning techniques in the context of medical tourism. Hence, this research aims to fill this gap and develop a new method to reveal travelers' choice preferences and satisfaction with medical tourism services through the analysis of the online review. Text mining and ontology approaches are used in the proposed method. The method can mine data from medical tourism websites, discover the satisfaction dimensions, and reveal the satisfaction level of medical tourists through textual reviews. We rely on the demographic information of medical tourists and ontological semantic filtering approaches to better detect the travelers’ preferences in medical tourism websites. The proposed method is evaluated through the numerical and textual reviews obtained from medical tourism websites. The results of data analysis showed that the proposed method is effective for big data analysis in the medical tourism context and may help medical tourism organizers to improve their medical tourism services to obtain a high level of medical travelers' satisfaction.

An ergonomics-driven QFD model to improve medical laboratory staff and patient satisfaction

Patient satisfaction is an important and frequently used outcome measure for the quality of healthcare services. Any increase in patient satisfaction scores translates directly into an improved reputation, customer loyalty, profitability, and growth. This study investigates the effect of a well-designed work environment on medical laboratory employee satisfaction and in turn on patient satisfaction. The Quality Function Deployment methodology is used to translate the voice of patients into a set of critical to quality ergonomic aspects that are converted to prioritized and actionable ergonomic processes. By understanding the importance of ergonomic process elements of medical laboratory employee satisfaction and their effect on patient satisfaction level, it is possible to make informed decisions about the workplace elements that need to be considered for improvement. The results of this study highlight the role and responsibilities of healthcare execution managers in creating ergonomics-based organizational policies and strategies, leading to improved healthcare quality performance and financial results.

A Staged Approach for Contouring of Temporal Deformities Using Porous Polyethylene and Lipofilling.

Many studies evaluated the effectiveness of a single reconstructive material during temporal cranioplasty, or in comparison to the outcome of another material. To our knowledge, no previous study evaluated a staged combination of reconstruction modalities during temporal cranioplasty. In a prospective interventional study, the authors combined high-density porous polyethylene (HDPP) implant insertion (stage I) with a following lipofilling session (stage II) in 8 patients scheduled for temporal cranioplasties. This two-staged approach was evaluated 6 months after each stage independently. The patients' satisfaction as regards the aesthetic outcome was evaluated through a 5-points Likert scale by the patients themselves. For every individual patient, this psychometric analysis was repeated by medical staff from other departments. Statistical analysis of the patients and medical staff satisfaction scores showed a statistically significant increase after the addition of lipofilling session (stage II) if compared to implant insertion only (stage I). Clinically, this outcome was maintained in a long-term follow-up ranged from 1 - 8 years. Nevertheless, 2 patients needed one more lipofilling session to obtain their satisfaction as regards the final aesthetic outcome. No other complications were recorded in this study. In conclusion, combining alloplastic and autogenous reconstruction modalities in a staged approach can suffice the reconstruction requirements for such temporal defects. After a long follow-up period, the insertion of high-density porous polyethylene implant with the addition of a following lipofilling session showed more evaluators' satisfaction in terms of the final aesthetic outcome.

Satisfaction Survey of Patients and Medical Staff for Telephone-Based Telemedicine During Hospital Closing Due to COVID-19 Transmission.

Introduction: Telephone-based telemedicine was temporarily permitted in Korea during the COVID-19 pandemic. The purpose of this study was to assess satisfaction with the telemedicine done during temporary hospital closing when in-person visits were not allowed due to in-hospital COVID-19 transmission.Methods: Survey questionnaires partially taken from a telehealth usability questionnaire (TUQ) were sent to 6,840 patients who used telephone-based telemedicine from February 24 to March 7, 2020. Questionnaires sent to patients and additionally created questionnaires to evaluate telemedicine were sent to medical staff (182 doctors and 138 nurses).Results: Response rates of patients and medical staff were 13.2% and 17.2%, respectively. Patients' satisfaction with telemedicine was significantly greater than medical staff's satisfaction for all five components taken from TUQ (all p = 0.000). In addition, created questionnaires showed good reliability, obtaining similar results between doctors and nurses (all p > 0.05). More than 85% of medical staff replied that telemedicine was needed in COVID-19, whereas more than 80% of them worried about incomplete assessment and communication of medical condition. Overall satisfaction with telemedicine by medical staff was 49.7%. The strength of telephone-based telemedicine was patients' convenience (53.4%). However, incomplete assessment of patients' condition (55.0%) was its weakness.Conclusion: Satisfaction with telephone-based telemedicine by patients was significantly greater than that by medical staff (doctors and nurses). Negative views for safety and inconvenience resulted in a greater proportion of dissatisfaction among medical staff. For safe application of telemedicine, medical staff insisted that developing a platform and creating guidelines should be needed.

АНАЛИЗ РЕЗУЛЬТАТОВ СОЦИОЛОГИЧЕСКИХ ИССЛЕДОВАНИЙ КАЧЕСТВА И ДОСТУПНОСТИ МЕДИЦИНСКОГО ОБСЛУЖИВАНИЯ

Sociological research is an important tool for assessing the social effectiveness of medical care, it allows you to analyze the quality of the organization of medical care and social satisfaction of consumers. This study is an analysis of the results of "Selective observation of the quality and availability of services in education, health and social services, employment promotion." This statistical observation has several advantages: complex procedure for forming a sample, coverage of the population in all constituent entities of the Russian Federation, including urban and rural population, ensure that the data is representative, and allow for complex analysis in the dynamics. As a result of sociological surveys of the population of the Russian Federation in 2015, 2017, 2019, it was determined that the share of respondents satisfied with the work of health center and diagnostic services remains low (less than half of the respondents). When interviewing respondents, the reasons for dissatisfaction with the work of the health center were highlighted, the “leader” among which is “the length of waiting in queues”. Moreover, the share of respondents who choose “the work of medical specialist” and “the lack of necessary equipment and drugs” as negative aspects in the provision of medical care on an outpatient basis is increasing. About half of the respondents are satisfied with the comfort of their stay, the availability of drugs and modern equipment in the hospital. Analysis of the main negative phenomena observed in the provision of medical care to the population made it possible to determine the leading trends, which remain the high cost of drugs and an increase in the volume of paid medical care. More than half of respondents noted a decline in the quality of medical services, insufficient equipment of health center and hospitals.

Medical service quality, patient satisfaction and intent to revisit: Case study of publichub hospitals in the Republic of Korea.

This study aimed to construct and test structural equation modeling of the causal relationship between quality of healthcare, patient satisfaction, and intent to revisit perceived by patients using regional hub public hospitals. In this study, data of 2,951 outpatients and 3,135 inpatients were collected using the "2018 Regional Hub Public Hospital Operational Evaluation." A structural equation model was used to understand the relationship between patient satisfaction and intent to revisit, and bootstrap analysis was performed. In the direct effect, outpatients were presented in the order of the physician's practice service, the hospital's environment, and patient satisfaction. Inpatients were in the order of the physician's practice service and, medical staff's kindness and consideration,; patient satisfaction was shown in this order. In the indirect effect, the outpatients were presented in the order of physician's practice service, medical staff's kindness and consideration, and hospital's physical environment. Inpatients were introduced in the order of medical staff's kindness and consideration, nurse's practice service, physician's practice service, and patient satisfaction. Regional hub public hospitals need high-quality medical services and efforts from all departments to treat patients with sincerity to improve patient satisfaction and increase intent to revisit.

Effect of a standardized patient encounter on first year medical student confidence and satisfaction with telemedicine.

Although the coronavirus 2019 (COVID-19) pandemic has accelerated the use of telemedicine platforms across the country, medical students may lack confidence in their ability to conduct satisfactory patient encounters and practice clinical medicine through telemedicine. To evaluate the role of a standardized patient encounter on first year medical student confidence and satisfaction in using telemedicine. One hundred and sixty two first year medical students recruited from Edward Via College of Osteopathic Medicine-Carolinas campus were surveyed on their confidence and satisfaction with using telemedicine platforms before and after conducting a patient encounter. Participant confidence and satisfaction were assessed with a five point Likert scale: "not confident," "a little confident," "somewhat confident," "confident," and "extremely confident." Of 162 students, 103 (63.6%) completed the preencounter survey and 74 (45.7%) completed the postencounter survey. Before the standardized patient encounter, 37 participants (35.9%) reported that they were "a little confident" and 20 participants (19.4%) reported that they were "not confident" in their ability to conduct a patient interview using a telemedicine platform. Following the encounter, 24 students (32.4%) reported feeling "somewhat confident", and 32 (43.2%) reported feeling "confident" in their ability. Medical students' confidence and satisfaction with telemedicine improved after a standardized patient telemedicine experience in this study. This experience allowed students to practice the unique skills required for telemedicine. Medical schools might consider adding a telemedicine curriculum and standardized patient experiences in the undergraduate medical setting.

A framework for medical tourists' satisfaction and loyalty by costumer segmentation and quality improvement

PurposeTourism industry is a profitable resource for countries and considered one of the main sources of income and job creation for economic development. Among the various types of tourism, medical tourism and its subsets are of great significance owing to their capabilities and competitive advantages. In this regard, the purpose of this research is to provide a framework to categorize customers based on the Zeithaml pyramid and then identify and provide strategies to create loyalty and attract customers of this industry.Design/methodology/approachThis study proposed a framework for medical tourists' satisfaction and loyalty. First, by studying the literature and data gathering from Yazd (one of the cities of Iran), the effective factors on the loyalty and attraction of medical tourists were identified. These factors have been prioritized for the medical tourists who are in the platinum category by the Pareto technique and Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) method. Next, the strategies provided by experts for loyalty and attraction of medical tourists were examined. Finally, the house of quality (HOQ) as the first matrix in quality functional deployment (QFD) was used to provide operational strategies for medical tourism satisfaction. The statistical population of this research consists of medical tourists, academic experts and active physicians of medical tourism in Yazd, one of the cities of Iran.FindingsThe study results indicate the importance of “hospital reputation” in medical tourists' satisfaction. Also, “achieving international standards”, “periodic customer satisfaction assessment” and “paying attention to social responsibilities” are recognized as the most important strategies to achieve the loyalty of the most profitable group of customers, namely platinum.Practical implicationsThis study covers both theoretical and practical aspects. Theoretically, this study developed a new framework for medical tourists' satisfaction by the Zeithaml matrix, TOPSIS, Pareto technique and QFD method. Furthermore, practically this study helps practitioners of medical tourism in medical tourists' satisfaction and loyalty.Originality/valueIn this study, in addition to identifying the effective factors on the loyalty and attracting medical tourists, a new framework was developed for medical tourists' satisfaction by segmentation the tourism by the Zeithaml matrix and providing operational strategies by the QFD technique.

Investigating the Relationship between Resident Physician Implicit Bias and Language Use during a Clinical Encounter with Hispanic Patients

ABSTRACT Prior research suggests that the implicit biases of physicians are negatively associated with quality of medical care and patient satisfaction among minority patients. However, relatively little is known about how physicians express these subtle forms of bias in patient interactions. This study examined the implicit and explicit anti-Hispanic biases of 53 resident physicians and the relationship between anti-Hispanic bias and language use during outpatient medical appointments with 291 Hispanic patients. Physician implicit bias was positively associated with use of interrogatives and work-related words and negatively associated with the use of prepositions and relativity-related words (e.g., words related to time and the future). These findings contribute to the growing body of evidence suggesting that, in addition to nonverbal and paraverbal behaviors, providers may communicate implicit bias to patients through the words they use during a clinical visit.

The analysis of patients’ revisits intention factors in sub-urban hospital

Revisit intention is a very important topic in a marketing context. However, previous literature is still rarely linked together with trust, satisfaction and two types of service, namely medical and non-medical with the hospital as the subject. Hospitals have the task of providing complete individual health services. This study aims to analyze the relationship between the quality of medical services and the quality of non-medical services on satisfaction, trust and revisit intention on the sub-urban hospitals. This research is a quantitative study using primary data from distributing questionnaires to 250 patients of the sub-urban hospitals. The data in this study were analyzed using the SEM (Structural Equation Model) method with AMOS 24 software. The results of this study indicate that the quality of medical services and the quality of non-medical services have a positive and significant effect on satisfaction. Meanwhile, patient satisfaction has a positive and significant effect on trust and revisit intention. However, trust was found to have a positive but insignificant effect on revisit intention. This research recommends several implications to the management of sub-urban hospitals. The managers of the sub-urban hospital are advised to pay more attention to and emphasize medical services, non-medical services, and patient satisfaction because it has been empirically proven to increase Revisit Intention

Care Process Improvement in Total Knee Arthroplasty Using the Concept of Patient Flow

Improving the process of care may effectively improve the quality of medical care and increase patient satisfaction. An investigation found that the process of care used in our unit was imperfect, resulting in a low preoperative enrollment rate of case managers, overly long patient waiting times for ward assignment, insufficient pre-operative knowledge, and high cancellation rates for routine operations. The aim of this project was to review the overall process of care using the concept of patient flow to improve and formulate countermeasures to improve quality of care. To improve the process of care, the corresponding countermeasures were formulated. 1. Set criteria for enrollment for orthopedic case managers to increase the preoperative enrollment rate; 2. Set up a specialized arthroplasty care area for central case management to reduce the time patients need to wait for the ward; and 3. Improve patient compliance with preoperative education and reduce the operation cancellation rate by distributing patient education pamphlets, filming videos of pre-operative instructions, facilitating home environment preparation, and providing education on sterilization baths. After implementation of the countermeasures, the preoperative case manager enrollment rate increased from 27.8% to 84.6%; the average ward wait time for patients reduced from 73 to 41 minutes; compliance with patient education increased from 83.0% to 100%; and the operation cancellation rate reduced from 11.1% to 0%. This project used the concept of patient flow to review the care process used for total knee arthroplasty. This improvement strategy may be used to standardize care processes and improve the quality of medical care provided.

Research on Analysis and Prediction of Elderly Medical Satisfaction Based on Convolutional Neural Network

In order to adapt to the development of economic and social aging, solve the practical problem of incomplete medical security system in China, and provide higher quality medical services to more elderly people. In this paper, a comprehensive and effective survey and data collection on the status quo of medical services for the elderly were conducted by means of questionnaire survey, and an evaluation index system affecting the satisfaction with medical services for the elderly was established by using SERVQUAL model. On this basis, this paper will survey the one dimensional data into two dimensional data, taking advantage of computer vision in depth study using convolution neural network model to generate satisfaction evaluation system for the weight of each index, and then using the trained network model as an effective assessment tools, effective training sample sets of the sample satisfaction accurately forecast, forecast results to improve the elderly health work provides some feasible suggestions.

Factors affecting revisit intention for medical services at dental clinics.

Recent changes in the medical paradigm highlight the importance of patient-centered communication. However, because of the lack of awareness of dental clinics and competency of medical personnel, the quality of medical services in terms of the communication between doctors and patients has not improved. This study analyzed the impact of health communication and medical service quality, service value, and patient satisfaction on the intention to revisit dental clinics. The study participants were outpatients treated at 10 dental clinics in Seoul. The research data were collected using a questionnaire during visits to these dental clinics from December 1 to December 30, 2016. A total of 600 questionnaires were distributed (60 copies to each clinics) and 570 valid questionnaires were used for the analysis. The influence of the factors was determined using structural equation modeling. The factors influencing service value were reliability (β = 0.364, p < 0.001), expertise (β = 0.319, p < 0.001), communication by doctors (β = 0.224, p < 0.001), and tangibility (β = 0.136, p < 0.05). In addition, the factors influencing patient satisfaction were reliability (β = 0.258, p < 0.001), tangibility (β = 0.192, p < 0.001), communication by doctors (β = 0.163, p < 0.001), and expertise (β = 0.122, p < 0.01). Further, service value (β = 0.438, p < 0.001) raised patient satisfaction, which was found to influence the intention to revisit dental clinics (β = 0.383, p < 0.001). Providing accurate medical services to inpatients based on smooth communication between doctors and patients improves patient satisfaction. In addition, doctors can build long-term relations with patients by increasing patients' intention to revisit through patient-oriented communication.

The Association of Microaggressions with Depressive Symptoms and Institutional Satisfaction Among a National Cohort of Medical Students.

Despite substantial research on medical student mistreatment, there is scant quantitative data on microaggressions in US medical education. To assess US medical students' experiences of microaggressions and how these experiences influenced students' mental health and medical school satisfaction. We conducted a cross-sectional, online survey of US medical students' experiences of microaggressions. The primary outcome was a positive depression screen on the 2-item Patient Health Questionnaire (PHQ-2). Medical school satisfaction was a secondary outcome. We used logistic regression to model the association between respondents' reported microaggression frequency and the likelihood of a positive PHQ-2 screen. For secondary outcomes, we used the chi-squared statistic to test associations between microaggression exposure and medical school satisfaction. Out of 759 respondents, 61% experienced at least one microaggression weekly. Gender (64.4%), race/ethnicity (60.5%), and age (40.9%) were the most commonly cited reasons for experiencing microaggressions. Increased microaggression frequency was associated with a positive depression screen in a dose-response relationship, with second, third, and fourth (highest) quartiles of microaggression frequency having odds ratios of 2.71 (95% CI: 1-7.9), 3.87 (95% CI: 1.48-11.05), and 9.38 (95% CI: 3.71-26.69), relative to the first quartile. Medical students who experienced at least one microaggression weekly were more likely to consider medical school transfer (14.5% vs 4.7%, p<0.001) and withdrawal (18.2% vs 5.7%, p<0.001) and more likely to believe microaggressions were a normal part of medical schoolculture (62.3% vs 32.1%) compared to students who experienced microaggressions less frequently. To our knowledge, this is the largest study on the experiences and influences of microaggressions among a national sample of US medical students. Our major findings were that microaggressions are frequent occurrences and that the experience of microaggressions was associated with a positive depression screening and decreased medical school satisfaction.