Assessing patient satisfaction. Part 1. The research process

Summary

• ? The research reported in this article formed part of a project evaluating nursing developments in four demonstration wards in one health authority, and the article focuses on evaluation of patient satisfaction.
• ? The evaluation of patient satisfaction is a topic surrounded by much methodological debate and therefore it was necessary to clarify the issues involved at the planning stage of the study.
• ? The ‘process’ aspects of evaluating patient satisfaction will be discussed here, while the content of patient interviews will be the subject of Part 2.

     

Predictors of patient satisfaction with inpatient hospital nursing care

The purpose of this predictive nonexperimental study was to investigate the influence of registered nurse (RN) job satisfaction, context of care, structure of care, patient-perceived nurse caring, and patient characteristics on patient satisfaction with inpatient hospital nursing care in an academic medical center in north-central West Virginia. Convenience samples of patients (N = 362) and RNs (N = 90) were recruited from two medical units, two surgical units, and three intensive care step-down units. Causal modeling identified patient-perceived nurse caring as the major predictor of patient satisfaction, with nurse/physician (RN/MD) collaboration as the only other direct predictor. Age had an indirect influence on patient satisfaction. Strategies to achieve and maintain patient satisfaction should address the enhancement of patient-perceived nurse caring and RN/MD collaboration.     

Associations between ward atmosphere, patient satisfaction and outcome

Previous studies have found important associations between the ward atmosphere and patient satisfaction. However, fewer studies have examined the relationship between ward atmosphere and outcome of treatment. The aim of the study was to examine whether or not differences in ward atmosphere were associated with differences in satisfaction and outcome. Eighty patients at three different ward units responded to a questionnaire at admission and by the time of discharge from the hospital. The questionnaire comprised the ward atmosphere scale, a five-item index of patient satisfaction, the Generalized Self-Efficacy Scale, an index of life satisfaction and the symptom checklist SCL-90R. The results showed that differences in the treatment environment between the ward units were associated with differences in patient satisfaction. There was mixed evidence for associations between ward atmosphere and outcome, while no associations were found between ward atmosphere and self-efficacy and life satisfaction. The results may suggest that the relationship between ward atmosphere and outcomes of treatment may be of a more indirect character than the relationship between ward atmosphere and satisfaction.     

Measuring the effect of patient comfort rounds on practice environment and patient satisfaction: A pilot study

Hourly rounding in the acute hospital setting has been proposed as an intervention to increase patient satisfaction and safety, and improve the nursing practice environment, but the innovation has not been adequately tested. A quasi-experimental pretest post-test non-randomized parallel group trial design was used to test the effect of hourly patient comfort rounds on patient satisfaction and nursing perceptions of the practice environment, and to evaluate research processes and instruments for a proposed larger study. A Patient Satisfaction Survey instrument was developed and used in conjunction with the Practice Environment Scale of the Nursing Work Index. Results on patient satisfaction showed no significant changes. Significant changes were found for three of the five practice environment subscales. Consistent with the aim of a pilot study, this research has provided important information related to design, instruments and process that will inform a larger sufficiently powered study.     

Patient satisfaction with nursing care and its relationship with patient characteristics

The aim of this study was to assess patient satisfaction with nursing care and the relationship between patient satisfaction and patient characteristics. This cross‐sectional study was conducted at a 1100‐bed tertiary care teaching hospital in Turkey. Data were collected using the Newcastle Satisfaction with Nursing Care Scales and a patient information form. Overall, data indicated a high level of patient satisfaction. Hospitalization affected the Experience of Nursing Care Scale independently, while the type of ward, sex, income, and education independently affected the Satisfaction with Nursing Care Scale. Patients who underwent surgical procedures, male patients, the 40–59‐year‐old age group, those who had low levels of education or income, and patients who were hospitalized for long periods were most satisfied. Patients' sex, age, income, duration of hospitalization, and ward type were important factors that affected their satisfaction with nursing care. The characteristics of patients who have a low level of satisfaction with nursing care should be assessed and taken into consideration by nurses.     

Measuring patient satisfaction with nursing care: experience of using the Newcastle Satisfaction with Nursing Scale

Patient satisfaction with care has frequently been used as a measurement of quality, especially in attempts to demonstrate the benefits of changes in nursing practice. Unfortunately such attempts have frequently failed as patient satisfaction ratings have lacked sensitivity, consistently achieving very high scores. They have also failed to isolate the nursing component from the whole health care experience. The Newcastle Satisfaction with Nursing Scale (NSNS) has been developed after extensive research work as an attempt to establish reliable and valid measures of patients' experiences of and satisfaction with nursing care. This study evaluated the use of the NSNS in practice and found that it was readily understood by patients and easily administered by clinical staff. However, several lessons were learnt which could help its administration. The results demonstrated a very high degree of satisfaction with nursing care which left the discriminatory ability of the scale open to question, although its potential benefits in standard setting were demonstrated. Further evaluative studies are needed if the potential benefits of the NSNS are to be fully realised.     

Unpacking the concept of patient satisfaction: a feminist analysis

AIM: The aim of this paper is to present a feminist critique of the concept of patient satisfaction. BACKGROUND: Fiscal restraint, health care restructuring, shifting demographics, biomedical technological advances, and a significant shortage of health care professionals are stretching health care systems across North America to the breaking point. A simultaneous focus on consumerism and health service accountability is placing additional pressure on the system. The concept of patient satisfaction, with roots in the consumer movement of the 1960s, has both practical and political relevance in the current health care system and is commonly used to guide research related to consumer experiences of health care. Because the quality of health care encounters may lead to treatment-seeking delays, patient satisfaction research may be an effective vehicle for addressing this public health issue. However, there is wide agreement that patient satisfaction is an under-theorized concept. Using current conceptualizations of patient satisfaction, we end up all too often producing a checklist approach to 'achieving' patient satisfaction, rather than developing an understanding of the larger issues underlying individual experiences of health care. We focus on the symptoms rather than the problems. DISCUSSION: Without further theoretical refinement, the results of research into patient satisfaction are of limited use. To push forward theoretical development we might apply a variety of theoretical lenses to the analysis of both the concept and the results of patient satisfaction research. Feminism, in particular, offers a perspective that may provoke further refinement of patient satisfaction as a concept. CONCLUSIONS: Without a deeper understanding of the values and beliefs (or the worldview) that informs our approaches to researching patient satisfaction, researchers will be reacting to the most obvious indicators and failing to address the underlying issues related to individual experiences of health care.     

An overview of patients' preference for, and satisfaction with, care provided by general practitioners and nurse practitioners

Aim and objectives. To assess patients’ views on the care provided by nurse practitioners compared with that provided by general practitioners and to determine factors influencing these views. Background. Many countries have sought to shift aspects of primary care provision from doctors to nurses. It is unclear how patients view these skill mix changes. Design. Cross‐sectional survey. Method. Patients (n = 235) who received care from both nurse and doctor were sent a self‐administered questionnaire. The main outcome measures were patient preferences, satisfaction with the nurses and doctors and factors influencing patients’ preference and satisfaction. Results. Patients preferred the doctor for medical aspects of care, whereas for educational and routine aspects of care half of the patients preferred the nurse or had no preference for either the nurse or doctor. Patients were generally very satisfied with both nurse and doctor. Patients were significantly more satisfied with the nurse for those aspects of care related to the support provided to patients and families and to the time made available to patients. However, variations in preference and satisfaction were mostly attributable to variation in individual patient characteristics, not doctor, nurse or practice characteristics. Conclusion. Patient preference for nurse or doctor and patient satisfaction both vary with the type of care required and reflect usual work demarcations between nurses and doctors. In general, patients are very satisfied with the care they receive. Relevance to clinical practice. In many countries, different aspects of primary care provision have shifted from doctors to nurses. Our study suggests that these skill mix changes meet the needs of patients and that patients are very satisfied with the care they receive. However, to implement skill mix change in general practice it is important to consider usual work demarcations between nurses and doctors.     

The patient satisfaction with nursing care quality: the psychometric study of the Serbian version of PSNCQ questionnaire

Scand J Caring Sci; 2012; 26; 598–606 The patient satisfaction with nursing care quality: the psychometric study of the Serbian version of PSNCQ questionnaire Introduction: Patient satisfaction with nursing is the most important predictor of patients’ overall satisfaction with their hospital care. According to the Law of Health Care of Republic of Serbia monitoring of patients’ satisfaction with hospital service is mandatory; however, the questionnaire applied to that purpose includes only several questions directly addressing the nursing care issue. Aim: The aim of the present study was to evaluate psychometric properties of the Serbian version Patient Satisfaction Nursing Care Quality Questionnaire (PSNCQQ) and explore patients’ satisfaction of nursing care they received and assess the relationship between patient satisfaction and patient characteristics. Methods: This cross‐sectional study included a sample population of 240 patients who were discharged from surgical clinics of the Clinical Center of Vojvodina in Novi Sad. The PSNCQQ was translated into Serbian according to standard procedures for forward and backward translation. Factor analysis was used to determine the construct validity, and predictive validity of the questionnaire was previously assessed. Cronbach’s α coefficient and item analysis was conducted to evaluate reliability of the scale. Results: The Serbian version Patient Satisfaction Nursing Care Quality Questionnaire (PSNCQQ) showed a one‐factor structure, Cronbach’s α reliability coefficient was excellent 0.94 and was similar across hospital categories. The correlation coefficient between 19 items and the total scale was high, and ranged from 0.56 to 0.76. Patients’ age, educational level and previous hospitalization period were important factors that affected their satisfaction with nursing care. Conclusion: The study provides a new tool for measuring patient satisfaction with nursing care in Serbia that may present a useful instrument for nursing care managers in improving the nursing care process.     

优质护理服务对产科基础护理质量及患者满意度的影响

目的探讨优质护理服务对产科基础护理质量及患者满意度的影响。方法选取优质护理服务应用前后在我院住院治疗的患者各1830例,比较优质护理服务开展前后产科基础护理合格率及患者满意度。结果应用优质护理服务后基础护理合格率由85．03％上升到93．99％;患者对护理服务的满意度由88．42％上升到96．39％,差异均有统计学意义（X2分别为78．252,82．979;P〈0．05）。结论优质护理服务有利于产科基础护理质量提高,促进护理事业的快速发展,值得在临床科室护理工作中推广应用。     

Relationship of nurses' assessment of organizational culture, job satisfaction, and patient satisfaction with nursing care.

This exploratory study investigated the relationship among staff nurses' assessment of organizational culture, job satisfaction, inpatient satisfaction with information about home care and follow-up, and general inpatient satisfaction with nursing care. A conceptual path model was tested using a secondary data analysis research design. Staff nurses and inpatients were sampled from inpatient units. The unit of analysis was patient care units. Pearson correlation and regression analyses were used. We found that strength of organizational culture predicted job satisfaction well and positively; job satisfaction predicted inpatient satisfaction significantly and positively; and inpatient satisfaction predicted general inpatient satisfaction well and positively. Methodological challenges of this study are discussed.     

提高老年病房服务满意率的做法与体会

老年人中枢神经系统及各脏器的退行性改变使老年病房护理难度及护理量加大、护患沟通障碍,病人对护士的服务难以达到满意。强化以老年病人为中心,围绕老年病人的特点,在临床工作中从多方面进行针对老年病人的护理,提高老年病房服务满意率收到了良好效果。     

人性化护理服务在我院的应用体会

目的探讨人性化护理服务模式,提升护理服务品质。方法通过对就医环境和程序、护理治疗、生活护理人性化服务的实施,采用护理质量考评问卷和满意度调查问卷,对我院2007年、2008年出院的患者进行评价,比较实施前后的效果。结果患者对护理服务的综合满意度由94.30%上升为97.10%,对健康教育、排忧解难、生活照顾、护患关系的满意度由93.80%上升为98.00%。护理质量考评问卷综合评价优质由92.00%上升为96.00%。结论人性化护理服务有效提高患者的满意度,调动了护士的积极性和创造性,提升了护理服务品质和医院的声誉,增强了医院的核心竞争力。