Determinants of Health Care Satisfaction:

This study examines the extent to which different health care attributes determine health care satisfaction. It employed two national cross-sectional samples, one of HMO members and the other of NON-HMO health care users. The comparative analysis revealed that the pattern of results for both samples were similar. The two most important attributes for both samples were health care costs and availability of specialists. Results suggest different marketing and related management strategies.     

Effects of an Integrated Care System on Quality of Care and Satisfaction for Children with Special Health Care Needs

To assess the effects of an Integrated Care System (ICS) on parent-reported quality of care and satisfaction for Children with Special Health Care Needs (CSHCN). In 2006 Florida reformed its Medicaid program in Broward and Duval counties. Children’s Medical Services Network (CMSN) chose to participate in the reform and developed an ICS for CSHCN. The ICS ushered in several changes such as more prior approval requirements and closing of the provider network. Telephone surveys were conducted with CMSN parents whose children reside in the reform counties and parents whose children reside outside of the reform counties in 2006 and 2007 (n = 1,727). Results from multivariate quasi-experimental models show that one component of parent-report quality of care, customer service, increased. Following implementation of the ICS, customer service increased by 0.22 points. After implementation of the ICS, parent-reported quality and satisfaction were generally unaffected. Although significant increases were not seen in the majority of the quality and satisfaction domains, it is nonetheless encouraging that parents did not report negative experiences with the ICS. It is important to present these interim findings so that progress can be monitored and decision-makers can begin to consider if the program should be expanded statewide.     

Health Literacy,Acculturation, and the Use of Preventive Oral Health Care by Somali Refugees Living in Massachusetts

This study investigated the impact of English health literacy and spoken proficiency and acculturation on preventive dental care use among Somali refugees in Massachusetts. 439 adult Somalis in the US ≤10 years were interviewed. English functional health literacy, dental word recognition, and spoken proficiency were measured using STOFHLA, REALD, and BEST Plus. Logistic regression tested associations of language measures with preventive dental care use. Without controlling for acculturation, participants with higher health literacy were 2.0 times more likely to have had preventive care (P = 0.02). Subjects with higher word recognition were 1.8 times as likely to have had preventive care (P = 0.04). Controlling for acculturation, these were no longer significant, and spoken proficiency was not associated with increased preventive care use. English health literacy and spoken proficiency were not associated with preventive dental care. Other factors, like acculturation, were more predictive of care use than language skills.     

Immigration,Health Care Access,and Recent Cancer Tests Among Mexican-Americans in California

Immigrants’ lower rates of cancer testing may be due to lack of fluency in English and other skills and knowledge about navigating US health care markets, lack of access to health services, or both. We analyzed 9,079 Mexican-American respondents to the 2001 California Health Interview Survey (CHIS) grouped as born in the US, living in the US 10 or more years, or living in the US less than 10 years. The CHIS provides the largest Mexican-American sample in a US survey. Access to care meant having health insurance coverage and a usual source of care. English proficiency meant the respondent took the interview in English. Multivariate logistic regression was used to predict outcomes. Respondents reporting more time in the US were more likely to report access to medical care and to report getting a cancer screening exam. Regardless of time in the US, respondents reporting access had similar test rates. Regression results indicate that time in the US and primary language were not significant relative to use of cancer screening tests, but access to care was. Cancer screening tests that are covered by Every Woman Counts, California’s breast and cervical cancer early detection program, had smaller gaps among groups than colorectal cancer screening which is not covered by a program. California is the only state with a survey able to monitor changes in small population groups. Understanding barriers specific to subgroups is key to developing appropriate policy and interventions to increase use of cancer screening exams.     

Segmentation of Mexican-Heritage Immigrants: Acculturation Typology and Language Preference in Health Information Seeking

With the fast growing number of Mexican immigrants in the United States, more attention is needed to understand the relationship between acculturation and language preference in health information seeking. Latent class analysis provides one useful approach to understanding the diversity in sample of Mexican immigrants (N = 238). Based on 13 linguistic, psychological and behavioral indicators for acculturation, four discrete subgroups were characterized: (1) Less acculturated, (2) Moderately acculturated, (3) Highly acculturated, (4) Selectively bicultural. A Chi-square test revealed that three sub-groups were significantly different in language preference when seeking health information. Less acculturated and moderately acculturated groups sought health information in Spanish, whereas the highly acculturated group preferred English for health information. Selectively bicultural group preferred bilingual health information. Implications for health campaign strategies using audience segmentation are discussed.     

Immigration,Acculturation and Chronic Back and Neck Problems Among Latino-Americans

Higher acculturation is associated with increased obesity and depression among Latino-Americans, but not much is known about how acculturation is related to their prevalence of back and neck problems. This study examines whether acculturation is associated with the 12-month prevalence of self-reported chronic back or neck problems among US-born and immigrant Latinos. We performed multivariable logistic regression analysis of data from 2,553 noninstitutionalized Latino adults from the 2002–2003 National Latino and Asian American Survey (NLAAS). After adjusting for demographic, physical and mental health indicators, English proficiency, nativity and higher generational status were all significantly positively associated with the report of chronic back or neck problems. Among immigrants, the proportion of lifetime in the US was not significantly associated. Our findings suggest that the report of chronic back or neck problems is higher among more acculturated Latino-Americans independent of health status, obesity, and the presence of depression.     

Pandemic Birthing: Childbirth Satisfaction,Perceived Health Care Bias,and Postpartum Health During the COVID-19 Pandemic

Maternal and Child Health Journal - To examine the impact of the COVID-19 pandemic on birth satisfaction and perceived health care discrimination during childbirth, and in turn, the influence of...     

门诊患者医疗服务满意度的多因素分析

目的分析门诊病人满意度的影响因素，为卫生行政部门进行行政决策提供依据。方法采用多元线性逐步回归，对问卷调查结果，用SPSS13．0统计软件予以分析。结果554例病人综合满意率95．31％；性别、年龄、居住地等8项人口学特征对综合满意度没有影响；医疗技术水平、医生服务态度、治疗费用、健康知识宣传、取药排队等候时间、检查时舒适性与就医环境方便等8项指标，对综合满意度的影响有统计学意义。结论采用多元线性逐步回归分析门诊病人满意度，能使测量与分析更具科学性。     

Perceptions of Health Care Providers' Communication: Relationships Between Patient-Centered Communication and Satisfaction

Specific communication practices of multiple professionals in health care settings can impact patient outcomes. This study, conducted at a large Children's Hospital, sought to determine the extent to which patient-centered communication (PCC) affected satisfaction with communication and with care itself. Parents of child patients (N = 195) reported on the communication practices of physicians, nurses, and hospital staff members during their most recent stay in the hospital. Surveys were completed on site. Health care providers' use of PCC behaviors, especially immediacy and perceived listening, was positively associated with satisfaction with care and with communication. In addition, PCC behaviors were perceived to be used more frequently with children in better health than with children with poorer health status.     

Acculturation and Health Care Utilization among Mexican Heritage Women in the United States

With the increasing Latino population in the United States, it is critical to examine the influence of the process of acculturation on health care practices and utilization. The purpose of this study was to evaluate the relationship between acculturation level and post-partum visit (PPV) compliance among Latinas participating in a larger psycho-educational intervention aimed at encouraging women to engage in positive healthcare practices. Acculturation was measured with the Bicultural Involvement Questionnaire which assigned participants to five categories: Assimilated, Separated, Moderate, Bicultural and Alienation. Logistic Regression analyses were conducted to predict post-partum visit attendance. Odds ratios and relative risk of not attending the post-partum visit are presented. Results suggest women in the Separation and Assimilation groups were less likely than bicultural group members to attend the PPV. The only other variable that was significant in this analysis is the group condition, indicating that the intervention group was more likely to attend the PPV than the control group. Women identifying as bicultural seem to participate more actively in their own healthcare as they draw on the cultural assets that have a positive influence on informal health practices, such as healthy eating and refraining from drug use. Bicultural group members can also use formal skills related to language and knowledge of the dominant culture to help effectively navigate the healthcare system. Implications for research, intervention and practice are discussed to improve healthcare practices and increase utilization among Latinas.     

Communication and Care in an Acute Cancer Center: The Effects of Patients' Willingness to Communicate About Health,Health-Care Environment Perceptions,and Health Status on Information Seeking,Participation in Care Practices,and Satisfaction

This study investigated the role of willingness to communicate about health (WTCH) among older patients in a state-of-the-art cancer center. Specifically, relationships were examined between patients' WTCH and their information seeking, perceptions of coping activities the center offered, and satisfaction with the center. The study also explored how those relationships may be mediated by patients' perceptions of the health-care environment and their health status. The results indicated that WTCH may play an important role in predicting information-seeking behaviors, perceived helpfulness of center-sponsored activities, and overall satisfaction with care received at the center. Evidence also was found that perceptions of the health-care environment mediated cancer patients' WTCH. The implications of these findings for communication theory and application, as well as limitations and future directions for research, are discussed.     

医疗卫生人员的工作满意度现况调查和比较研究

目的描述不同机构医疗卫生人员工作满意度现状及其差异。方法结构问卷调查,样本机构是上海市某区所有卫生机构、医院和社区卫生服务中心,抽样方法为20%比例系统抽样,计划调查1 047人,实际回收问卷937份,问卷回收率为89.5%。调查内容为人际关系、工作前景、工作条件、医院管理、相对报酬、工作压力、工作强度、社会地位和职业风险。采用因子分析和百分折算法进行数据分析。结果医疗卫生人员对人际关系满意程度最高,为88分;对相对报酬满意程度最低,为60分。这个结果在3类机构之间有一致性。此外,医院医疗卫生人员对各方面的满意程度明显低于社区卫生服务中心和卫生机构,尤其是社会地位。结论应当全面提高医疗卫生人员的薪酬待遇,同时改善医院医疗卫生人员的社会地位。     

The Language of Mentoring in a Health Care Environment

In this article, 4 models were tested on the relations among mentoring, job expectations, job reward value, job involvement, and organizational commitment of hospital nurses. In the model with the best fit to the data, mentoring and job expectations were positively related to job reward value. Organizational commitment and job involvement were increased by job reward value. A direct effect on organizational commitment was found for mentor assistance in learning skills. Specific methods used by mentors to convey supportive communication to their prob5gCs included encouraging them to do their best, helping them gain additional training, providing support and encouragement when others criticize, helping deal with jealousy, and providing proteges with needed information. Nurse mentors were admired for standing up to administration and for challenging unfair decisions, thoughtless actions, and lack of respect on the part of administrators, doctors, and patients. Nurses indicated that working hard and not having anyone notice, being frequently criticized and rarely rewarded, and being exposed to serious diseases were particularly challenging and stressful aspects of nursing. Implications of this study for nurses and those working in health care environments are that mentoring and organizational commitment may be avenues for increasing the degree to which nurses feel that their job is rewarding.     

脑卒中住院患者医疗服务满意度调查及分析

目的了解脑卒中住院患者医疗服务满意度现状及影响因素,为对策制定提供参考。方法对山东省某市某三级甲等医院2011年10～12月的脑卒中住院患者进行现场问卷调查。结果脑卒中住院患者医疗服务总体满意度为73.5%。维护患者安全(80.5%)、维护患者权利(79.3%)、医疗技术(77%)、服务态度(77%)满意度高于总体满意度,是医院的竞争优势;医疗费用满意度最低(40.2%),是医院改进的重点;服务环境(67.8%)及服务流程(62.1%)也需要改进,但应量力而行。结论维护患者安全及权利应长抓不懈;高超的医疗技术及良好的服务态度应继续保持并持续提升;医院应加强收费管理,增进费用的公开透明程度;应努力保持环境的干净、整洁、舒适;应重点加强服务环节的管理,努力提供优质、高效的服务。     

Patient Proactivity: Behaviors,Attitudes, and Its Relationship With Satisfaction With the American Health Care Delivery System

A sample of 1,031 U.S. adult residents provided information regarding actions that fall within the realm of patient proactivity, that is to say efforts that are overtly designed to maintain or regain one's health. An assessment of consumers revealed that they engage in, or at least support, behaviors that would be characterized as proactive. Furthermore, there is a significant relationship between some elements of patient proactivity and the level of satisfaction with the American health care system. The relationships are modest, but they offer managerial insight that will benefit those responsible for both delivering and marketing health care.     

Immigration Status,Acculturation, and Dating Violence Risk for Hispanic Adolescent Girls in New Mexico

Maternal and Child Health Journal - Little data exist on dating violence experienced by immigrant Hispanic adolescents. The present study examined the relationships between immigration status,...