Overall Satisfaction Of Patients Research Articles

The Influence Of Relationship Quality Perceived Service Performance and Service Price On Service Price On Overall Satisfaction and Image : An Empirical Study

This study aims to investigate the influence of (1) Relationship quality, perceived service performance, and service price, on overall satisfaction. (2) Relationship quality and perceived service performance, on dental clinics’ image. (3) Overall satisfaction on Dental clinics’ image. Based on a dataset collected from 471 patients in Beirut, the results of regression analysis reveal, as hypothesized, that there is a positive relationship with regards to (1), (2) and (3). Moreover, the results indicate that the service price exhibits the most influence on the overall satisfaction of patients, while the relationship Quality has the most influence on the dental clinics' image. The study concludes with recommendations for dentists and direction for future researches context.

Assessing Patient’s Satisfaction using SERVQUAL Model: A Case of Sunyani Regional Hospital, Ghana

The interaction between patients and healthcare providers is critical as it influences patients’ satisfaction. This encounter provides the patient with the opportunity to assess and evaluate service quality and conversely it offers the provider an opportunity to manage patients’ perceptions and service quality. This study was conducted at Sunyani Regional Hospital in Ghana to assess patients’ satisfaction using SERVQUAL model by Parasuraman et al., (1988). The SERVQUAL instrument was adapted and modified to capture the relevant data. A total of 214 patients were employed in the study. Data were analysed using SPSS (version 16.0) for descriptive statistics and patients’ satisfactions were determines by the service quality gap model. The result indicated that the overall satisfaction of patients concerning the service quality of the hospital was good. On the other hand the gap scores showed negative gaps for four of the service quality dimensions out of six used in the study, indicating that patients were not satisfied with the service quality in relation to those dimensions. This therefore calls for management action to improve service delivery in those areas. These dimensions were Reliability, Communication/interpersonal relationship, Assurance, and Responsiveness. On the contrary, Tangibility and Empathy dimensions scored positive which affirms patients’ impression about the service.

Outcome of Anterior Cervical Discectomy and Fusion Using Surgical Loupe

Background Data: ACDF using the surgical microscope is the gold standard treatment for cervical radiculopathy, myelopathy or myeloradiculopathy due to herniated cervical disc and/or uncovertebral spurs, since it was first developed in 1950. Complications of ACDF, reported in the literature, have very low incidence rate except laryngeal and pharyngeal complications (dysphagia, dysphonia) with reported incidence of 5.7% to 93.3%.Purpose: To find out the possibility and safety of use of surgical loupe alone as an alternative to the gold standard surgical microscope. Study Design: observational analytic retrospective study. Patients and Methods: Retrospective evaluation of outcome of 59 cases of surgically treated cervical disc disease done using surgical loupe alone instead of microscope inAin Shams university hospitals. Results: The mean VAS of axial neck pain and radicular pain decreased significantlyimmediately postoperatively (P value 0.001>). Radicular weakness improved immediately postoperatively (P value 0.032). Myelopathy improved significantly after 1 month (P value 0.004).The overall satisfaction of patients was excellent in 47.4% (28 cases) and very good in 37.3% (22 cases) with overall highly satisfactory results 84.7% of patients. The mean interval to return to work after surgery (in months) was 1.98±0.55. The mean of operation time (in minutes) of ACDF was 112.71±44.55. Conclusion: Surgical loupe could be good alternative to microscope in ACDF in resources- limited centers. (2014ESJ075)

OCT imaging of the anterior eye

OCT imaging of the anterior eye

Novel diagnostic methods for the assessment of the anterior eye

Novel diagnostic methods for the assessment of the anterior eye

Unsedated versus sedated gastrointestinal endoscopy: A questionnaire investigation in Wuhan, central China

National data show that in China mainland unsedated gastrointestinal (GI) endoscopy has been applied in most hospitals for clinical examination, while sedated GI endoscopy is only performed in some hospitals. The purpose of this study was to compare sedated versus unsedated GI endoscopy regarding cost, safety, degree of comfort, tolerance level and overall satisfaction of patients over a 6-month period investigation. From March to September 2011, a questionnaire survey was performed on 1800 patients and 30 physicians at Zhongnan Hospital of Wuhan University and Wuhan General Hospital of Guangzhou Military Command. The patients fell into two groups according to their own decisions: the unsedated group (n=1000) and the sedated group (n=800). After examination, the patients and the physicians were required to fill in a questionnaire form. All the data were analyzed statistically. The results showed that the main factors the patients took for consideration between sedated and unsedated procedures included economy, comfort and safety. The income levels between the sedated and unsedated groups showed significant difference (P<0.01). Most patients in the unsedated group had lower income and were covered by less medical insurance. The tolerance rate was 92.4% vs. 65.5% between the sedated and unsedated group, respectively. 95.5% patients in the sedated group and 72.1% patients in the unsedated group chose the same endoscopy procedure for repeat examination. The survey data from endoscopists suggested the sedated procedure was more comfortable but less safe than the unsedated procedure (P<0.01). In China, unsedated GI endoscopy is now widely accepted by the majority of patients due to low cost and safety. Compared to unsedated GI endoscopy, sedated GI endoscopy is less painful, but more expensive and less safe. With the rapid improvement of people's living standard and the reliability of sedation technology, we expect sedated GI endoscopy will be gradually accepted by more patients.

Long-Term Symptom Improvement and Overall Satisfaction After Prolapse and Incontinence Graft Removal

We report long-term symptom improvements and overall satisfaction in patients after removal of grafts used in pelvic reconstruction in a tertiary referral center. We analyzed patients who underwent graft removal for treatment of related complications and who were followed for at least 2 years. Symptoms were determined by patient self-assessment questionnaires. Seventy-nine patients underwent partial or complete graft removal from 2005 to 2011 and met inclusion criteria. The mean follow-up time was 4.0 years (median, 3.4 years; range, 2.0-7.6 years). Forty-seven percent (37 patients) had implants for both prolapse and incontinence, 40% (32 patients) had incontinence implants only, and 13% (10 patients) had prolapse implants only. Thirty percent of those with both implants presented with multiple symptoms compared to 50% of those with prolapse implants and 44% of those with incontinence implants only. At follow-up, 75% (56 patients) reported that their symptoms were better and 15% (11 patients) reported that their symptoms were worse. Of patients who underwent graft removal for pain alone, 74% (17 patients) improved whereas17% (4 patients) were worse. When asked about spending the rest of their lives with their current symptoms, 49% (38 patients) reported positively whereas 44% (34 patients) reported negatively. Forty-one patients underwent one or more additional treatments. Graft-related complications are often treated with surgical excision. In a cohort of 79 patients in whom implants were removed an average of 4 years earlier, 75% still report symptom improvement and 49% report good quality of life. However, many patients still feel dissatisfied and sought additional treatment during long-term follow-up. These data can be used to counsel patients considering removal of pelvic reconstruction grafts.

Identifying Drivers of Overall Satisfaction in Patients Receiving HIV Primary Care: A Cross-Sectional Study

ObjectiveThis study seeks to understand the drivers of overall patient satisfaction in a predominantly low-income, ethnic-minority population of HIV primary care patients. The study’s primary aims were to determine 1) the component experiences which contribute to patients’ evaluations of their overall satisfaction with care received, and 2) the relative contribution of each component experience in explaining patients’ evaluation of overall satisfaction.MethodsWe conducted a cross-sectional study of 489 adult patients receiving HIV primary care at two clinics in Houston, Texas, from January 13–April 21, 2011. The participation rate among eligible patients was 94%. The survey included 15 questions about various components of the care experience, 4 questions about the provider experience and 3 questions about overall care. To ensure that the survey was appropriately tailored to our clinic population and the list of component experiences reflected all aspects of the care experience salient to patients, we conducted in-depth interviews with key providers and clinic staff and pre-tested the survey instrument with patients.ResultsPatients’ evaluation of their provider correlated the strongest with their overall satisfaction (standardized β = 0.445, p<0.001) and accounted for almost half of the explained variance. Access and availability, like clinic hours and ease of calling the clinic, also correlated with overall satisfaction, but less strongly. Wait time and parking, despite receiving low patient ratings, did not correlate with overall satisfaction.ConclusionsThe patient-provider relationship far exceeds other component experiences of care in its association with overall satisfaction. Our study suggests that interventions to improve overall patient satisfaction should focus on improving patients’ evaluation of their provider.

Patient responses to Er:YAG laser when used for conservative dentistry

The utilization of laser technology in conservative dentistry offers several advantages compared with traditional instruments, but one of the still unsolved problems is the difficulty in describing and explaining these advantages to patients. The aims of this study were to verify the efficacy of the way patients are informed and to evaluate their satisfaction with laser-assisted treatment. Before treatment, 100 patients were given a brochure that explained the relevant laser-assisted dental procedures, and after dental treatment an 11-item questionnaire was administered to the patients to evaluate their satisfaction with the treatment. Statistical analysis showed high levels of satisfaction for all the questions, especially those regarding the choice between laser therapy and traditional instruments (100%), choosing laser in the future (89%), and recommending it to family and friends (84%). This study may be relevant when determining the overall satisfaction of patients with this new technology.

Determinants of Patient Satisfaction After Orthopedic Interventions to the Hand: A Review of the Literature

Treatment effectiveness is increasingly evaluated from the patients' perspective. However, the interpretation of satisfaction is complex because the patient's perception of a satisfactory outcome is influenced by numerous factors. The objective of this study was to identify which factors are associated with patient satisfaction after orthopedic interventions to the hand. A literature review was conducted, including studies on determinants of satisfaction with treatment outcome or unspecified overall satisfaction of patients with hand problems. The results indicate that patient satisfaction is determined by multiple factors. There is moderate evidence that pain/symptoms, activities of daily living/function, aesthetics, and embodiment influence patient satisfaction. Furthermore, data indicate a correlation of strength, range of motion, fulfillment of expectations, deformity, workers' compensation, and length of follow-up with satisfaction. Knowledge about these determinants may lead to a more detailed decision-making process, thus contributing to improved treatment outcomes and cost-effectiveness. Level of Evidence V.

Outcome of stapled hemorrhoidopexy versus doppler-guided hemorrhoidal artery ligation for grade III hemorrhoids

To evaluate the long-term results, early and late complication rates, and overall satisfaction of patients with grade III hemorrhoids treated by stapled hemorrhoidopexy (SH) or Doppler-guided hemorrhoidal artery ligation (DGHAL). Operative and follow-up patients' data were prospectively collected for patients undergoing either SH or DGHAL by a single surgeon during a 2-year period. A retrospective comparison between patients' outcome operated by one of the two methods was made based on this data. Clinical data on postoperative pain, analgesic requirements, time to first bowel movement and functional recovery were collected at five postoperative follow-up visits (1 and 6 weeks, 6, 12, and 18 months). Data on patient satisfaction, recurrence of hemorrhoidal symptoms and further treatments were obtained by a standardized questionnaire that was conducted during the last visit 18 months postoperatively. A total of 63 patients underwent SH (aged 52 ± 3.2 years) and 51 patients underwent DGHAL (aged 50 ± 7.3 years). DGHAL patients experienced less postoperative pain as scored by pain during bowel movement (2.1 ± 1.4 vs. 5.5 ± 1.9 for SH), and required fewer analgesics postoperatively. Hospital stay, time to first bowel movement, and complete functional recovery were also significantly shorter for the DGHAL patients. Nine DGHAL patients (18%) suffered from persistent bleeding or prolapses and required additional treatment compared with 2 (3%) patients in the SH group. SH patients reported greater satisfaction compared with DGHAL patients at 1 year postoperatively. Both SH and DGHAL are safe procedures and have similar effectiveness for treating grade III hemorrhoids. DGHAL is less painful and provides earlier functional recovery, but is associated with higher recurrence rates and lower satisfaction rates compared with SH.

Transversus Abdominis Plane Block Reduces the Analgesic Requirements After Abdominoplasty With Flank Liposuction

The transversus abdominis plane (TAP) block is a technique of locoregional anesthesia that blocks the sensorial afferent nerves localized between the transversus abdominis muscle and the internal oblique muscle. We describe results obtained with a case control study between patients undergoing abdominoplasty with the TAP block compared with a similar group of patients not receiving the block. Medical notes were reviewed, and patients were classified according to the presence of TAP. Outcomes evaluated were the requirements of morphine in the first postoperative hour and the number of co-codamol tablets administered afterward. Seventy-five patients were screened. No intra- or postoperative complications were recorded. TAP+ patients required significantly less analgesia during the first 12 postoperative hours (P < 0.001). The patients with increased body mass index and large flap resected were more likely to fail the anesthetic block and required postoperative analgesia. In aesthetic abdominal surgery, the TAP block is safe, is performed without ultrasound guidance, and markedly reduces the requirement of postoperative opioid analgesia. Future studies will now confirm these results and evaluate the consequences in terms of postoperative nausea, vomiting, and overall satisfaction of patients.

Experience with TVT-SECUR sling for stress urinary incontinence: a 141-case analysis

The objective of this study was to investigate complications, urinary incontinence symptoms, and overall satisfaction in patients undergoing the tension-free vaginal tape-SECUR (TVT-S) for stress urinary incontinence (SUI). We reviewed consecutive patients treated with TVT-S between April, 2006 and August, 2007, in a urogynecology practice. Outcomes assessed included complications, voiding function, change in SUI symptoms on the Medical Epidemiological and Social Aspects of Aging (MESA) questionnaire, and overall satisfaction. One hundred forty-one women (age, 54.1 +/- 12 years; BMI, 31.2 +/- 6.6 kg/m(2)) were treated for SUI with the TVT-S; 34 required concomitant procedures. There were no intra-operative complications. Immediate post-operative voiding function returned in all but one patient; none required sling release. Most patients (90%) reported no pain on a verbal pain scale. On follow-up, 117 patients denied SUI symptoms, 16 reported mild symptoms, and eight required additional treatment. The average MESA "stress" subscore decreased by 79% (13.0 +/- 7.8 points, p < 0.0001). Eighty-five percent felt "satisfied" with the procedure. TVT-S is a safe and effective treatment for SUI.

Clinical Safety and Efficacy of a Novel Thermoreversible Polyhexanide-Preserved Wound Covering Gel

Background: An ideal topical formulation for wound therapy does not exist. The aim of this study was to develop a novel improved therapeutic option for the treatment of acute and chronic wounds. Methods: A transparent wound gel which is in a liquid state below and in a gel state at or above room temperature was developed. Forty-four patients were included in this open randomized controlled single-center study. Flammazine™ served as control in the treatment of skin graft donor sites. Wounds were assessed for time of dressing change and overall satisfaction of patients and health care providers. The data were analyzed using the nonparametric Mann-Whitney test. Results: The wound gel proved to be superior in comparison with Flammazine with respect to wound assessment (p = 0.002), staining (p = 0.007), leaking (p = 0.032) and smell (p = 0.034). Flammazine showed favorable results regarding the parameters dehydration of the dressings (p = 0.012) and wound adherence (p = 0.005). The evaluation of the overall dressing change process showed no significant differences. Conclusion: The thermoreversible wound gel containing polyhexanide allows for good handling and wound assessment. This study demonstrated a high satisfaction level of patient and health care providers, and the wound gel proved an effective alternative to commonly used treatments.

Satisfacción de los pacientes de urgencias con los cuidados enfermeros

Objective To measure the overall satisfaction of patients with nursing care during their stay in the emergency unit, evaluating the satisfaction with specific professional skills and the degree of information provided by nurses at discharge. Method A descriptive cross-sectional study conducted at the Ramon y Cajal University Hospital. The subjects of study are those patients who come to the emergency unit and met the inclusion criteria. A mean of 840 people were seen weekly, and it was estimated to collect 200 questionnaires over a period of one week. The questionnaire was self-administered. The variables analyzed were: clinical, sociodemographic, satisfaction and problem solving. The instrument used was the Consumer Emergency Care Satisfaction Scale (CECSS). The Statistical analysis was performed using SPSS 16.0 software package. Categorical variables are expressed in absolute and relative frequency; and continuous variables are expressed as the mean and the standard deviation. Asymmetric behavioral variables are described by their median, the interquartile interval and the non-parametric test of Kruskal-Wallis. Results We surveyed 200 patients and we studied 198 patients who expressed high levels of overall satisfaction and satisfaction with professional competence. The degree of information at discharge is the dimension worst noted. No association was found between patient satisfaction and sociodemographic variables. The satisfaction was higher in patients who returned home than in those who were admitted in the hospital, the dimension of information at discharge being very significant. Conclusions We need to improve the information provided by the nursing staff to patients at discharge.

Effectiveness and Safety of a Novel Gel Dressing in the Management of Neuropathic Leg Ulcers in Diabetic Patients: A Prospective Double-Blind Randomized Trial

Neuropathic leg ulcers (NLUs) affect more than 10% of diabetic patients with peripheral neuropathy and represent the most common cause of ulceration of the leg in these patients. Though their pathogenesis is well known, related to the chronic neuropathic edema, the management of NLUs, mainly based on elastocompression, is still controversial, with lower healing rates than nondiabetic venous leg ulcers. The authors tested if a novel gel formulation, containing amino acids and hyaluronic acid (Vulnamin)gel; Errekappa, Milan, Italy), will improve the outcomes of NLUs when used together with elastocompression. Thirty patients affected by NLU were randomized into 2 groups, both treated with 4-layer elastocompressive bandaging: patients in group A were topically treated with the application of Vulnamin) gel, whereas patients in group B received only the inert gel vehicle. The healing rate at 3 months was evaluated as the primary endpoint, whereas the secondary endpoints were healing time, reduction in ulcer area and ulceration score in 4 weeks, number of infective complications, and overall satisfaction of patients. Healing rate was significantly (P < .05) higher in patients in group A when compared with those in group B; healing time, patients' satisfaction, and reduction in ulcer area and ulceration score in 4 weeks were also higher in patients in group A. However, no significant differences were found in the prevalence of infections and other adverse events. The use of Vulnamin) gel with elastocompression is safe and effective in the management of NLUs of diabetic patients.

Patient Self-Administered Abdominal Pressure to Reduce Loop Formation During Minimally Sedated Colonoscopy

Assistant-administered abdominal pressure is usually required to reduce loop formation during a colonoscopy. The effect of patient self-administered abdominal pressure has not been evaluated. To compare the effectiveness of patient self-administered abdominal pressure with assistant-administered abdominal pressure to reduce loop formation during colonoscopy performed with minimal sedation. Consecutive patients who underwent colonoscopy were randomized to receive either patient self-administered abdominal pressure (patient group, n = 51) or assistant-administered abdominal pressure (assistant group, n = 52) when looping occurred during colonoscopy minimally sedated with meperidine. When patient-administered abdominal pressure failed to reduce the loop formation, an assistant took over and delivered the abdominal pressure. No difference was found regarding cecal intubation rate, intubation time, mean pain scores, and overall satisfaction of patients between groups. However, fewer patients required assistant-administered pressure in the patient group than in the assistant group (18/51 vs. 41/52, P < 0.001). Patient self-administered pressure is effective in reducing looping during minimally sedated colonoscopy.

Satisfaction of inpatients with acute coronary syndrome in Bulgaria

BackgroundPatient satisfaction constitutes an important indicator for the quality of care. During the last years, Bulgaria changed its socialist health care system to a market-driven system. Despite the fact that the improvement of health care quality and patient satisfaction were put on top of the list of goals for the health care reforms, no studies of patient satisfaction with inpatient care have been conducted so far.Since cardiovascular diseases are amongst the major causes of death in Bulgaria, and strenuous efforts have been made to improve the quality of medical care of patients with acute coronary syndrome (ACS) during the last years, patient satisfaction in this group can be seen as an important example of the Bulgarian reforms. This study therefore investigates patient satisfaction of inpatients with ACS.MethodsWe performed structured face-to-face interviews with all patients with ACS, residing in a representative Bulgarian region who were discharged from hospitals in this region between September 1st and December 31st, 2004. We surveyed their socio-demographic status, overall satisfaction, change in complaints, self-perceived health status, functional possibilities in activities of daily living, satisfaction with life and self-reported condition at admission. We used descriptive methods as well as t-tests, chi-square tests, and logit models for data analysis.ResultsFace-to-face interviews were carried out in 394 cases, of which 53.6% were men and 46.4% were women. 24% of the patients were satisfied with inhospital treatment, 62% were satisfied to some extent, and 14% were unsatisfied. The overall satisfaction of patients with ACS was significantly associated (p < 0.05) with the type of hospital, the number of family members living together and the severity of the disease at admission. Patients treated in urban and middle-size rural hospitals, patients living together with three or more family members, and patients with more severe conditions at admission reported higher satisfaction scores.ConclusionACS patient satisfaction with inhospital treatment in Bulgaria shows much room for improvement. Information obtained from satisfaction studies could be used at decision-making and hospital-management levels for improving new strategies and structural changes in the Bulgarian health care system.

Peritonsillar infiltration with bupivacaine and pethidine for relief of post‐tonsillectomy pain: a randomised double‐blind study

Previous studies of infiltration of local anaesthetics in children undergoing tonsillectomy resulted in conflicting results. The aim of this study was to evaluate the effect of the peritonsillar injection of bupivacaine and pethidine on postoperative pain in children undergoing snare-dissection tonsillectomy. In a double-blind study, 80 children (aged 7-15 years) were randomly divided into two groups receiving peritonsillar injection of either bupivacaine (1 mg x kg(-1)) and pethidine (1 mg x kg(-1)) in adrenaline 1:200,000 (treatment group) or an equivalent volume of saline (placebo group) pre-operatively. The time needed for first demand of analgesia and analgesic consumption to reduce the visual analogue scale (VAS) for resting throat pain to < or = 30, the VAS for pain on swallowing, drinking liquid and eating a soft diet, incidence of nausea and vomiting, and the need for rescue anti-emetics in the first 24 h after operation were compared in both groups. The combination of bupivacaine and pethidine could significantly decrease the consumption of analgesics for resting pain at 4, 6, 8, 12, and 24 h after operation but did not reduce pain on swallowing, drinking liquid and eating a soft diet. The times to demand of first dose of analgesic and to first oral intake were not significantly different. The overall satisfaction of patients in relation to relief of postoperative pain was not significantly different between the two groups. Although peritonsillar injection of pethidine and bupivacaine in children reduces the analgesic consumption, it does not affect the dynamic pain state in the first 24 h after snare-dissection tonsillectomy.

Myotomy: Follow-Up Study of 50 Patients

Laparoscopic myotomy has become the standard treatment for definitive management of achalasia. This study was undertaken to assess the long-term results of the procedure. Perioperative data, including a symptom score questionnaire, were collected prospectively on all patients undergoing laparoscopic myotomy. The same questionnaire was readministered by phone to patients with follow-up greater than 3.75 years. The long-term success of myotomy was defined as a 50% or greater decrease in the dysphagia score and absence of further therapy (responders). Fifty of 95 patients (age = 57 years, 23 females) were successfully contacted. Average follow-up was 6.2 years. The overall long-term success rate was 64% (responders). Forty-two patients (84%) were able to gain or maintain their weight after the procedure. Five patients (10%) required one or more endoscopic dilations after the myotomy. The mean change in dysphagia score was higher in the responder group (7.8 +/- 1.9 vs. 1.9 +/- 2.1; P = 0.001). The two groups were similar in terms of age, gender distribution, and follow-up interval (P > .05). Dor fundoplication was performed in six patients (12%), and the outcome comparisons of these patients showed no significant differences from those patients undergoing Heller alone. Overall satisfaction was achieved in 94% of contacted patients. These results confirm that laparoscopic myotomy is an effective procedure with excellent long-term symptom resolution and overall satisfaction in patients with achalasia.