Consumer issues in navigating health care services for type I diabetes

• Despite increasing interest in consumer awareness and participation in health care service delivery, there has been little exploration of consumer views in relation to services for people with type I diabetes. • The purpose of this qualitative exploratory study was to identify strategies people with type I diabetes used to access health services and the barriers they perceived in accessing the services they needed. • Data gathered in semi-structured interviews revealed that consumers experience significant barriers when navigating the health care system. • Three dominant themes were identified. They relate to access to specialist medical skill, to the transition from teenager to young adult and to pre-pregnancy and obstetric care. • Directions for change in service delivery and policy development are discussed.

Multiple visions or multiple aversions? Consumer representation, consultation and participation in maternity issues

This paper reviews the Commonwealth government's policy of 'purposeful reporting to consumers'. I argue that the notion of consumer participation is underdeveloped. Consumers' needs will not be fully met by confining consumer representation at the administrative level; that is, in assuming that consumer advocates may speak for other consumers of health care services. The partnership objective at the heart of 'purposeful reporting' may be addressed fully only when practitioners and providers recognise the reciprocal expertise of the consumer in defining their own health priorities. This would require a new model of knowledge, of ethics and of the clinical encounter. The problem is not one of information deficit but of contrasting views of knowledge.

Endometriosis, an unknown entity: the consumer`s perspective

This paper reports the findings of a consumer-driven investigation conducted by the Centre for Clinical Nursing Research at Epworth Hospital in conjunction with the Endometriosis Association (Victoria, Australia) aimed at identifying the information and support needs of women experiencing endometriosis. Women's experiences of endometriosis and laparoscopy were examined. A questionnaire was designed to explore women's experiences of, and informational need for, the four categories of: diagnosis of endometriosis, endometriosis, laparoscopy and managing at home. A total of 465 women who had a positive diagnosis of endometriosis, including patients at the Epworth Endometriosis Centre and members of the Endometriosis Association, were included. The data were analysed in terms of frequency of responses and themes that arose from the research. Five main themes consistently emerged from the overall analysis of the questionnaire; these included: lack of communication, no-one listens, the emotional turmoil, expressions of gratitude to the Endometriosis Association and being young and helpless. Also identified was a lack of understanding of endometriosis and laparoscopy, on behalf of both the patient and the practitioner, which has led to communication of misinformation, extended physical pain and emotional distress. Based on these findings, recommendations were made for education strategies to be focused towards increasing awareness of endometriosis and for information to be disseminated using the preferred printed format and to be made available from gynaecologists, hospitals and schools. Through consumer participation, the information obtained in this study is of benefit to all women who come in contact with endometriosis by (a) validating women's experiences of endometriosis and (b) identifying women's needs in relation to the disease.

Trust and e-commerce: a study of consumer perceptions

Increasing use of the World Wide Web as a B2C commercial tool raises interest in understanding the key issues in building relationships with customers on the Internet. Trust is believed to be the key to these relationships. Given the differences between a virtual and a conventional marketplace, antecedents and consequences of trust merit re-examination. This research identifies a number of key factors related to trust in the B2C context and proposes a framework based on a series of underpinning relationships among these factors.

Pharmaceuticals and the consumer movement: the ambivalences of 'patient power'

Consumer and patient advocacy groups (PAGs) are important participants in the politics of pharmaceuticals. Yet very little is known about the precise nature and extent of their influence. It is argued in this article that PAGs fulfil a mixed role within the health system at national and transnational levels, and that they are at times fully incorporated into economic and political power structures. Their frequent dependence on pharma industry funding is of particular concern. PAGs provide a means of direct industry interaction with the final customer, thereby partially bypassing and putting additional pressure on doctors and regulators. The article presents the case for research to establish a better empirical base for discussions about the role of PAGs within contemporary neo-liberal governance structures.

Consumer satisfaction and post-purchase intentions: an exploratory study of museum visitors

This paper examines the relationship between consumer satisfaction and subsequent intentions in the museum context, as well as the moderating influence of demographic characteristics such as gender, age and education in that relationship. The relationship between satisfaction and a range of service elements, overall satisfaction with the experience and intentions was investigated. Museum marketers can profit by examining the "value chain" of museum experience outlined in the model presented, especially the greater likelihood of consumers recommending the experience to others than making a repeat visit themselves, and by investigating segment differences beyond those reported here.

Conceptualizing the ιnfluence of the self-service technology context on consumer voice

The self-service technology (SST) context is characterized by consumer participation in service production and delivery, independent of service personnel; a lack of interpersonal interaction between consumers and service personnel; and consumers being required tointerface and interact with technology. With these features of the SST context in mind, in situations where SSTs fail to perform as promised, some challenges arise: consumers who are dissatisfied do not have the security or reassurance of service personnel to assist them; service personnel do not have the opportunity to prompt consumers to voice their dissatisfaction; and consumers need to initiate their own complaint response. If consumers fail to report their dissatisfaction directly to the organization, organizations will not know that a problem exists and may experience negative consequences such as consumer switching behavior. As reports of consumer dissatisfaction with SSTs become increasingly common, it is important, therefore, to investigate how organizations with SST-based offerings can encourage consumers to voice their dissatisfaction directly to the organization. Although the antecedents of consumer voice are well documented in the interpersonal services context, in the context of SSTs they have been subject to very little conceptual or empirical scrutiny. This paper argues that voice needs to be revisited with respect to SSTs due to their unique characteristics compared to interpersonal services, and presents a conceptual model of the antecedents of consumers' voice behavior in the context of SSTs.

Understanding consumer adoption of internet banking : an interpretive study in the Australian banking context

This paper reports key findings from an interpretive study of Australian banking consumer experiences with the adoption of internet banking. The paper provides an understanding of how and why specific factors affect the consumer decision whether or not to bank on the internet, in the Australian context. A theoretical framework is provided that conceptualizes and links consumer-oriented issues influencing adoption of internet banking. The paper also provides a set of recommendations for Australian banks. Specifically, the findings suggest that convenience is the main motivator for consumers to bank on the internet, while there is a range of other influential factors that may be modulated by banks. The findings also highlight increasing risk acceptance by consumers in regard to internet-based services and the growing importance of offering deep levels of consumer support for such services. Gender differences are also highlighted. Finally, the paper suggests that banks will be better able to manage consumer experiences with moving to internet banking if they understand that such experiences involve a process of adjustment and learning over time, and not merely the adoption of a new technology.

Consumer complaint actions: a conceptual model based on complainants about advertising in Australia

This article presents a new conceptual model detailing consumer complaint responses relating to exposure to unacceptable advertising. The model is initiated by consumer perceptions of negative inequity which elicits one of three consumer complaint responses based on the identified triggers that may influence complaining propensity such as demographic, psychographic, cultural, situational and social factors. Complainant perception of the process encountered together with the overall outcome of their experience affect future complaint behaviour as shown by this evolving model as the end reaction flows on to form the consumer’s next response to a similar situation. The advertising industry in Australia is valued annually at over $8 billion and some advertisements have been identified as ‘unacceptable’ by elements in society. Industry and regulatory response to consumer complaints is thus an important area to address and there is no extant literature utilising such an holistic model.

Patient or consumer? The colonization of the psychiatric clinic

Information is given a privileged place in the psychiatric clinic, as illustrated by the prevalence and volume of data to be collected and forms to be completed by psychiatric nurses. Information though is different to knowledge. The present paper argues that information is part of a managerial discourse that implies commodification whereas knowledge is part of a clinical discourse that allows room for the suffering of the patient. Information belongs to the discourse of managerialism, one that positions the patient as customer/consumer and in doing so renders them unsuffering. The patient's suffering is silenced by their construction as a consumer. The discourse of managerialism seeks a complete data set of information. By way of contrast, another discourse, that of psychoanalysis offers the institution the idea that there are always holes, gaps, and uncertainty. The idea of uncertainty, gaps, things remaining unknown and a limit sits uncomfortably with the dominant discourse of managerialism; one that demands no limits, complete data sets, and many satisfied customers. This market model of managerialism denies the potential of the therapeutic relationship; that something curative might be produced via the transference. In addition, the managerialist discourse potentially positions the patient as both illegitimate and unsuffering.

Consumer acceptability of low fat foods containing inulin and oligofructose

Inulin and oligofructose were used as fat replacers in Anzac cookies, blueberry muffins, carrot cake, chocolate cake, lemon cheesecake, ice cream, and beef sausages at levels ranging from 4 to 13g/100g, achieving a significant reduction in fat content (20% to 80% relative). These foods were rated as acceptable by an untrained taste panel, but scored consistently lower than their full-fat counterparts (controls). Regression analysis showed that, unlike the controls, texture was more important than flavor in determining overall acceptability of the low-fat foods. Inulin and oligofructose are readily incorporated into bakery and meat formulations, but their use might be limited by adverse physiological effects when consumed at high levels.

Consumer complaint behaviour and relationship marketing: a research agenda

A void identified within the Relationship Marketing literature is the lack of research on dissatisfactory or problem relationships, so the utilisation of work that has been conducted in the area of Consumer Complaint Behaviour (CCB) is appropriate. Therefore, this paper identifies ways in which the CCB literature may be used to advance knowledge in the field of Relationship Marketing. As the context of this paper is consumer - service provider relationships, an assessment is made of some of the implications of technology-infusion in service encounters, at two levels, namely at the broad relationship marketing level, that is, the likely impact of technology infusion on consumer - service provider relationships, and then more specifically regarding implications for CCB.

The impact of service intangibility on consumer service quality expectations

Research consistently demonstrates the strategic benefits of providing quality in service delivery (Tse and Wilton 1988; Anderson and Zeithaml 1984). However, to deliver a quality service, it is first necessary to determine the level of quality expectations that consumers have for a particular service industry. This paper examines whether quality expectations vary across services based on their degree of total intangibility. A controlled, repeated measures design is utilised, whereby subjects are each asked to evaluate three services that vary in their degree of intangibility. Contrary to past findings, results indicate that consumer expectations for service quality do not vary with the level of intangibility of the service.