Client Perceptions Research Articles

Provider Types and Perceived Mental Health Discrimination in Health Care Settings: Results of a Canadian Nationally Representative Sample

An exploratory investigation was conducted to assess the influence of provider types on a client's perception of mental health stigmatization in a health care setting. A subsample of respondents (n = 2,323) to the Canadian Community Health Survey-Mental Health was included in the analysis. We used multiple regression to investigate the potential associations between provider types and number of providers seen for persons with mental health concerns experiencing health-care-related stigma. Seeking help from some groups was associated with increased odds of experiencing health care provider stigma. Seeing more professionals was also associated with an increased likelihood of experiencing health care provider stigma. The results clarify that individuals who experience mental illness often perceive discrimination and prejudice when seeking mental health treatment. Given the impact of stigma on treatment-seeking behavior, it is plausible that some mental health providers are contributing to the client's choice not to seek care.

Client perceptions improve with collaborative care when managing dogs with cancer: a Collaborative Care Coalition study.

Collaboration between primary care veterinarians (pcVets) and veterinary oncologists is common for dogs diagnosed with cancer, but no data exist that explore dog owner utilization and perceptions of collaborative care. The objectives were to describe dog owner perceptions of the value of collaborative veterinary cancer care and identify drivers of a positive collaborative care experience between the pcVet and oncologic specialists. 890 US dog owners who had pets diagnosed with cancer in the past 3 years. Online contextual survey. Data were analyzed using group comparisons and multiple regression analysis. Significance was set at P < .05. 76% of clients sought specialty care following cancer diagnosis in their dog. Seventy percent of owners across all income brackets indicated that referral to a specialist was a very good value based on money spent and outcomes. Delayed referral resulted in lower client satisfaction scores for pcVets. Top predictors of client satisfaction with pcVets were as follows: responsiveness to questions, staying involved with their dog's care, and willingness to work with other veterinarians and specialists. For specialists, top predictors were as follows: providing accurate cost estimates, cancer knowledge, and effectiveness of care. Client perceptions of pcVets were 6 times more likely to improve following referral to a specialist. All were significant predictors of owner advocacy (P < .0001). Dog owners perceived early collaboration between pcVets and specialists favorably, fostering client satisfaction and positive perceptions of the value for service provided for dogs diagnosed with cancer.

Therapist Multicultural Orientation: Client Perceptions of Cultural Humility, LGB Identity, and the Working Alliance

ABSTRACT Little attention has been given to how therapist cultural humility may benefit lesbian, gay, and bisexual (LGB) clients. Thus, the current study examined whether therapist cultural humility predicted stronger client-therapist working alliances in a sample of 333 LGB individuals. LGB identity centrality (IC; the extent to which a person’s LGB identity is central to their overall identity) and LGB identity affirmation (IA; the extent to which an LGB person associates their sexual orientation with positive thoughts or feelings) were considered as moderators. Therapist cultural humility predicted stronger working alliances between LGB clients and their therapist; however, this association was not moderated by IC or IA. The present results suggest that LGB clients who rated their therapists as culturally humble toward their sexual orientation also reported stronger working alliances with their therapist, regardless of IC or IA. Lastly, exploratory analyses revealed that lower therapist cultural humility ratings were associated with greater sexual orientation acceptance concerns, internalized homonegativity, difficulties coming out, and sexual orientation concealment. The clinical implications of these findings are discussed. Future research should consider the benefits of therapist cultural humility for other gender and sexually diverse persons.

The Influence of Competence and Experience of Auditors on Audit Outcomes

This qualitative study investigates the influence of auditor competence and experience on audit outcomes in the realm of financial governance. The research aims to explore the lived experiences and perceptions of auditors, clients, and other stakeholders regarding these critical attributes. Adopting a phenomenological approach, data was collected through semi-structured interviews and focus group discussions with purposively sampled participants. Thematic analysis revealed key insights into auditor competence and experience. Competent auditors were found to possess advanced technical skills, critical thinking abilities, and professional judgment, enabling them to navigate complex audit engagements effectively. Meanwhile, experienced auditors were noted for their deep understanding of industry nuances, client operations, and regulatory requirements, contributing to audit effectiveness and reliability. The interplay between competence and experience emerged, highlighting their symbiotic relationship in enhancing audit quality. The findings underscore the importance of continuous learning and development initiatives to maintain auditor competence and the need for diverse audit experiences to accumulate valuable experiential knowledge. This study sheds light on the multidimensional nature of auditor competence and experience and their profound impact on audit outcomes, providing valuable insights for auditing practices and regulatory frameworks.

Telerehabilitation: An Updated View of Practices, Cost Analysis, and Client Perceptions

Telerehabilitation is an alternative and complementary rehabilitation method in which information and communication technologies are used to remove the distance between healthcare professionals and clients. The COVID-19 pandemic has led to the rapid adoption of telerehabilitation services, limiting the in-person rehabilitation services available all over the world. The restrictions that started with the COVID-19 pandemic also negatively affected rehabilitation services, clients, and healthcare professionals, and it was considered essential to provide services using telerehabilitation technology. Therefore, this review aimed to examine and inform health professionals' telerehabilitation practices such as remote assessment, evaluation, intervention, monitoring, supervision, education, and follow-up during the pandemic. This review aimed to present the practice areas, advantages, disadvantages, perceptions, and cost analysis results of telerehabilitation practices to healthcare professionals, considering the standards the American Telemedicine Association set.

Newly arrived migrants meet street-level bureaucrats in Jordan, Sweden, and Turkey: Client perceptions of satisfaction–dissatisfaction and response strategies

Abstract The article examines how newly arrived Syrian refugees experience and navigate their encounters with street-level bureaucrats (SLBs) in three urban settings: Adana, Turkey; Gothenburg, Sweden; and Irbid, Jordan. The encounters took place in the context of local government institutions responsible for assisting refugees upon their arrival in the host society. The broader question examined is how refugees respond when experiencing dissatisfaction with their encounters with SLBs in the receiving country. In our analysis, we draw upon the Exit, Voice, Loyalty, Neglect model suggesting different patterns of response to dissatisfaction with public services. We also deploy an additional, understudied response type, Gaming. The degree of satisfaction–dissatisfaction experienced by Syrian refugees and the kind of response strategies they resorted to as a consequence of that experience varied notably from country to country. Syrian refugees in Gothenburg and Adana felt more dissatisfied with and frustrated by their encounters with SLBs than their compatriots in Irbid. The responses of the refugees in Adana were mostly of the Exit and Neglect type. In Gothenburg, on the other hand, interviewees primarily resorted to Neglect and Voice responses, while in Irbid Gaming, Exit, and Loyalty were the most common response strategies opted for to express and act upon one’s dissatisfaction.

Service Quality Delivery of Benadir Local Government in Somalia

Purpose: In today’s competitive and rapidly moving world, local governments lose so many citizens because of the poor quality of public services they provide for these products, because of the quality and/or lack of products and the lack of ability to provide quality service. The purpose of this study is to examine the service quality delivery of the Benadir local government in Somalia. Theoretical framework: This research studied the degree service quality delivery offered of the Benadir local government in Somalia. Service quality has been defined as a difference between customers' service perception and expectations. Methodology: To achieve the objectives of this study, data was collected through online questionnaire from a sample of 354 major customers of the Benadir local government in Mogadishu-Somalia. These respondents were selected using convenient random sampling method. The data collected from the online questionnaire were analyzed using Descriptive Statistical tools such as compute, percentage, mean, and standard deviation. Findings: The results of this study indicate that the three out five dimensions of level quality service delivery (reliability, responsiveness, and assurance) have slightly positive satisfied and except two elements empathy and tangibility have negative satisfied with customers' expectations and perception. Furthermore, customers were most a little satisfied with the three dimensions of service quality delivery by the Benadir local administration in Mogadishu-Somalia. On the contrary, customers were negative satisfied with tangibility and empathy dimensions of service quality. Research limitation/ implication: The researcher forwards some recommendations for the Benadir local government in Somalia. In order to improve the level of citizen satisfaction in terms of quality service delivery offered by the Benadir local government in Somalia, the Benadir local government should come up with policies and programs that prioritize the level of citizen satisfaction and should develop and contribute the level client expectation and perception of dimensions quality service delivery by the Benadir local government in Somalia, the Benadir local government should make the information easily obtainable and can get prompt service delivery by the citizens, therefore, the study recommends that a strategy should be put in place to gain these benefit. The limitations faced by the study included time constraints and limited resources taken to complete the study. Originality/Value: This investigation differs from previous explores as it examines the influence of level service quality delivery in Benadir local government on outcomes and operations in particular. Furthermore, this study is specifically based on the Benadir Regional Government.

Client perception on quality of Antiretroviral therapy (ART) services and retention in care among Key populations receiving care in Edo state, Nigeria.

Client perception on quality of Antiretroviral therapy (ART) services and retention in care among Key populations receiving care in Edo state, Nigeria.

Nursing Care in Tn. N And Tn. R with Problems of Sensory Perception Disorders: Hearing Hallucinations

Hallucinations are the client's perception of the environment without any real stimulus, which means the client interprets something real without external stimulus. The purpose of this writing is to describe the nursing management of sensory perception disorders: auditory hallucinations in Mr. N and Mr. R at RSJ Palembang. The method used is to provide management in the form of patient care to control the auditory hallucinations they experience. Patient management was carried out for 5 days for Mr. N and Mr. R. Data collection techniques were carried out using interview techniques, physical examination and observation. Management results showed that clients were able to control the auditory hallucinations they experienced, namely by shouting, having conversations, scheduled activities and taking medication. Clients are able to overcome the hallucinations they experience as a whole so that the treatment given can provide optimal results. Suggestions for RSJ are expected to improve nursing care for sensory perception disorders: hallucinations by involving clients in various activities in the room so that clients remain focused and do not get lost in their hallucinations

A longitudinal investigation of the relationship between Chinese counseling trainees’ anxiety and client symptom outcome

ABSTRACT Objective This study examined the reciprocal association between counseling trainees’ trait and state anxiety and their clients’ symptom distress and the mediating effects of working alliance. Method Data set included 6,888 sessions conducted by 211 master’s level beginning therapists with their 1,216 clients in China. Trainees completed a measure of trait anxiety at the beginning of practicum. Before each session, trainees completed the state anxiety measure and clients reported their symptom distress; and after every session, both the trainees and clients rated their perceived working alliance. Results Multilevel modeling showed that (a) Therapist trainees’ level of trait anxiety did not predict overall client outcome in terms of symptom reduction. (b) At the session-to-session level, higher therapist state anxiety before one session significantly predicted higher client distress before the next session, and higher client distress before one session significantly predicted higher therapist state anxiety before the subsequent session. (c) Therapist and client perceptions of working alliance were both significant mediators of the reciprocal relationship between therapist state anxiety and client distress. Conclusions Findings suggested that it was trainees’ state anxiety, instead of trait anxiety, that reciprocally related to client symptom outcome at the session-to-session level. Implications for clinical training were discussed. PRACTICAL IMPLICATIONS A generally more anxious therapist trainee does not seem to have worse overall clinical effectiveness compared with a generally less anxious trainee. From session to session, trainees who experience less state anxiety tend to establish a stronger working alliance with their clients, which leads to more client symptom relief. Evidence suggests against selecting trainees based on their trait anxiety level; but it is recommended that supervisors help trainees manage their state anxiety before a session.

Therapist and client perceptions of empathy in simulated teletherapy sessions

ABSTRACT Empathy is thought to be reduced in videoconference (VC) compared to face-to-face (F2F) therapy. To empirically test this possibility, therapist and client ratings of empathy and its correlates were examined in VC and F2F sessions. Forty-eight students in clinical training programs were randomly assigned to the role of ‘therapist’ or ‘client’, forming 24 dyads. Each dyad completed a simulated clinical session in F2F and in VC and reported on empathy and telepresence. Both therapist and client ratings of empathy were significantly lower in VC compared to F2F. Therapist empathy correlated with telepresence, particularly its physical subcomponent, and therapeutic presence, but these associations were not found for clients. The relationship between empathy and telepresence was investigated further in a real-world study. Twelve clients met with clinical psychology trainees over VC and reported on empathy and telepresence. The associations between therapist empathy, total telepresence, and the physical component of telepresence were replicated. Again, client ratings of empathy and telepresence did not correlate. These results provide the first empirical evidence that empathy is reduced in VC teletherapy compared to F2F and highlight the connection between the degree of empathy felt by therapists and their sense of telepresence during teletherapy.

SME clients evaluation of audit quality: the roles of auditors' communication effectiveness, rapport and social capital

PurposeThis study examines how professional service firms' communication effectiveness (affiliative communications style, social dialogue and information provision), social cognitive capital and rapport established between an auditor and SME client are instrumental in influencing the latter's evaluation of the technical quality of an audit.Design/methodology/approachThe study combines qualitative and quantitative methodologies to create a cross-sectional survey covering four geographic regions in an emerging economy – Thailand. The authors examine the hypotheses by employing social interaction theory.FindingsA study of 744 SME executives plus post-survey interviews with three audit partners revealed that an affiliative communications style and information provision are positively associated with the rapport developed between financial auditor and client, and that rapport, in turn, had a strong association with client perceptions of audit quality. In addition, affiliative communication style, information provision and social cognitive capital had a direct (positive) association with perceptions of audit quality. The effects of communication effectiveness and social cognitive capital varied, depending on whether or not the SME client possessed formal accounting qualifications.Originality/valueThe study contributes to the literature on the business-to-business professional services, and accounting in particular, by explicating the important roles of communication effectiveness, rapport, and social cognitive capital in the relationship between an auditor and a client. Moreover, the paper reveals that the differences in educational background of clients result in differential impacts of communication effectiveness and social cognitive capital on rapport and perceptions of audit quality.

Timor-Leste’s Coffee Diversification. A Case Study of Hospitality Industry in Dili, Timor-Leste

The study aims to identify the clients' perceptions regarding Timor coffees' diversification to enhance the value marketing in the hospitality industry (1). Also, the objective of this study is to create a prototype of Timor's coffee instant based on the client's perception (2). The population of this study is the coffee lover clients, and the undefined sample of the clients was used as simple random sampling, which is 384 participants, and the key informants are 12 informants. This study applies a mix-method study of qualitative and quantitative study. The data collection method conducted observation, in-depth interviews, and surveys using questionnaires, and the data analysis used narrative and descriptive analysis. The result of this study is that most of the informants mentioned that the good quality of coffee is arabica coffee. They mostly agreed with the coffee diversification to enhance the value of Timor-Leste coffee. Also, the good quality of coffee starts from harvesting, fermentation, roasting, and preparing the coffee. Furthermore, regarding the clients' perceptions, 86% of clients agree with the diversification of Timor-Leste's coffee to be competed in the marketing, 65% strongly agree with drinking original Timor-Leste coffee. Moreover, 57% is clients' perception regarding Timor-Leste coffee instant and herbal (ginger and cinnamon) and 87% strongly agree that this diversification could increase the coffees’ farmer income. Moreover, the results of the prototype coffee of this study are Herbal drip original coffee mix with ginger and cinnamon, Timor-Leste coffee 2in1 and 3in1, and Timor-Leste coffee capsule (ginger and cinnamon). The benefit of this study is for clients to consume Timor-Leste's coffee instant, and thus, the reduction of importing coffee instant to Timor-Leste. Also, it is beneficial for agriculture area, especially coffee farmers, to plant more coffee as it is essential for farmers, clients, and the nation's national income.

Learning as a way of achieving quality improvement in long-term care: A qualitative evaluation of The Story as a Quality Instrument

Aim/ObjectiveThis study aimed to evaluate the use of the narrative quality instrument ‘The Story as a Quality Instrument’ (or SQI) for learning as a way of achieving quality improvement. BackgroundLearning is a widespread aim in long-term care. If professionals share detailed information about their views on the quality of care, they can see it from each other’s perspective and create a new joint perspective that may generate a broader meaning in total. One useful source for learning and improvement is the narratives of older adults. These narratives enable reflection and learning, which encourages action. In care organizations, there is a drive to find methods that can be used to facilitate learning and encourage quality improvement. DesignA qualitative evaluation design. MethodsData collection was performed in 2021–2022 at six field sites of four large care organizations providing long-term care to older adults in the Netherlands. At each field site, SQI was applied: an action plan was formulated in a quality meeting and, 8–12 weeks later, the progress was evaluated in a follow-up meeting. The data collected was participants’ responses during focus groups: the verbatim transcripts of both meetings and the observation reports of the researchers. 46 participants took part in the quality meetings and 34 participants were present at the follow-up meetings. The data was analyzed using thematic analysis. ResultsThe results are mechanisms that help learning, participant responses, and practical challenges and conditions. Four mechanisms became visible that encourage learning among participants for achieving quality improvements: in-depth discussions, exchange of perspectives, abstraction, and concretization. The participants listed several outcomes regarding individual learning such as change of attitude, viewing older adults more holistically and the realization that possibilities for working on quality improvement could be just a small and part of everyday work. Participants learned from each other as they came to understand each other’s perspectives. The added value lay in getting insights into the individual perceptions of clients, the concrete areas for improvement as an outcome, and getting a picture of the perspectives of diverse people and functions represented. Time was found to be the main challenge when applying SQI. ConclusionsSQI is deemed promising for practice, as it allows care professionals to learn in their workplace in a structured way from narratives of older adults in order to improve the quality of care.

Understanding the Role of Race in Doula Communities: Florida Doulas’ Perceptions of Maternal Health Disparities [ID: 1377606

INTRODUCTION: This study, part of a larger qualitative project, spurred significant participant feedback related to BIPOC (Black, Indigenous, people of color) clients’ needs for support from racially similar doulas. As such, this study analyzed the data to investigate how doulas navigate client perceptions of race. METHODS: Seven in-depth interviews and six focus groups were conducted with doulas serving in Florida (n=31). Transcripts were coded post-inter-coder agreement using an inductive approach to thematic analysis. Participant consent and IRB approval were obtained. RESULTS: 1) White doulas reported Black doulas advising them to refrain from taking on Black, Brown, non-English speaking clients and instead to refer when possible. Some participants explained tendency for implicit bias and discrimination when White doulas try to step into the perspective of clients of color, specifically Black women, despite good intent in trying to support a community facing health disparities. 2) A few doulas referred to White doulas reaching out to non-White clients as a savior/virtue signaling act, while others countered that White doulas can use their racial status for advocacy in medical settings. CONCLUSION: Doulas shared a desire to work with underserved families and discussed that issues surrounding race must first be acknowledged in order to create safer spaces for open communication surrounding maternal health, thereby mitigating disparities. It is important to note that our study relied on convenience sampling, utilizing predominantly White doulas, limiting our data on Black doula experiences and their perceptions on the role of race in the doula–client relationship. Future directions must include diversification of participants and speaking directly with Black doulas.

“It's your fault!” – said a public client to modernity advocates: an exploration of UK public sector’s viewpoints on the modern methods of construction

Purpose The staggering demand for construction projects to meet a spectrum of public needs is projected to outstrip the industry’s supply capability. The modern methods of construction (MMC) offers wider control due to shifting key construction processes offsite. Public clients play a significant role due to their purchasing power; however, their uptake of MMC is low, despite the benefits. The purpose of this study is to reveal the reasoning behind such low adoption. The research gap, herewith, is our lack of understanding of the influence of public clients perceptions on their adoption’s indecision. Design/methodology/approach This study used a qualitative approach to investigate the motives behind the public sector’s low MMC adoption. Semi-structured interviews with 14 of the United Kingdom’s public sector decision-makers, industry leaders and experts have been conducted. Perspectives were argued against the diffusion of innovation (DOI) theory. Findings Overall, the innovation’s attributes informed the authors of the positive perceptions from the public sector, demonstrating that the low adoption of MMC is not linked to any embedded issues with the innovation itself rather being predominantly related to the dynamics between supply and demand. The former (supply), reflected a failure in communicating confidence, and the latter (demand), attained characteristics that are limiting wider uptake. Originality/value To the best of the authors’ knowledge, this is the first study to apply the DOI theory to reveal the relationship between UK public clients’ perceptions and their decision-making. Moreover, this paper addresses the scant attention to the use of theories to explain the flow of innovations in the construction context.

Price Adjustment Practices and Their Impacts on Bridge Construction Contracts

This paper assesses the patterns and trends of price fluctuations and price adjustment practices in RCC T-beam and prestressed bridge construction contracts. Using a questionnaire survey, we conducted a descriptive research to document the existing practices. The perceptions of clients and contractors were measured using mean score and standard deviation on issue, followed by a consistency check. We then analysed the major components of price adjustments to identify trends. Price adjustment provisions are planned during the procurement planning and bid preparation stages of procurement cycle, and are used as necessary during the contract implementation stage. These provisions are meant to give protection to the contractor against price escalation. In the absence of any compensation provision in bridge construction contracts, price fluctuation can affect the time, cost and quality parameters of construction projects. This may lead to delays or cancellation of projects, reduced number of bidders, poor quality, problems with cash flow, and loss of interest of stakeholders in the project. The research draws attention to the serious issues of price adjustments among bridge projects to ensure constructability. This is the first attempt to address the issue in bridge contracts of Nepal and can serve as a starting point for further research on this topic

Therapeutic Communication of Nurses in the Surgical Treatment Room of RSUD Arifin Nu’mang

The quality of health services is what refers to the level of perfection of health services in causing satisfaction in each patient. The more perfect the satisfaction felt, the better the quality of health services. In organizing efforts to maintain the quality of health services in hospitals, it is inseparable from the nursing profession which plays an important role because nursing services ensure the existence of high-quality nursing care in quality control programs in hospitals, considering that nursing services take place continuously for 24 hours a day. The nursing service team provides services to clients in accordance with professional beliefs and established standards, this shows that the nursing services provided are always safe services and can meet the needs and expectations of clients. The purpose of this study was to determine the relationship between educational background with the implementation of therapeutic communication of nurses in the surgical treatment room of Arifin Nu'mang Hospital Sidenreng Rappang. This research methodology is a non-experimental research with descriptive research type, with observational research form. The research design in this study is Cross Sectional. Data in this study were obtained by finding respondents who fit the inclusion criteria then giving or distributing questionnaires to respondents. From the univariate analysis, the results obtained between verbal therapeutic communication as much as 63.5% who perceived well and non-verbal nurses as much as 85% who perceived well. The conclusion in this study is that the client's perception of the nurse's therapeutic communication shows quite good results.

Text Mining in Business. A Study of Romanian Client's Perception with Respect to Using Telecommunication and Energy Apps

Text Mining in Business. A Study of Romanian Client's Perception with Respect to Using Telecommunication and Energy Apps

Anticipating self-stigma: The roles of values and perceptions of therapy clients.

Anticipating self-stigma: The roles of values and perceptions of therapy clients.