Patients' satisfaction with community treatment: a pilot cross-sectional survey adopting multiple perspectives.

ACCESSIBLE SUMMARY: Patients' satisfaction is scarcely studied within the context of community treatment for adolescents. Thus, this study adopts a multiple perspective on patients' satisfaction (including service users as well as staff members). The results highlighted that all informants (patients, foster carers in foster homes and professional caregivers from community treatment teams) perceived the patients to be satisfied, with foster carers reporting the highest patient satisfaction rate. Considering the patient satisfaction rate from multiple perspectives provides complementary understandings. Clinical outcomes and, specifically, a reduction in emotional difficulties were related to patient's satisfaction, but only from the patients' perspective. ABSTRACT: Community treatment (CT) teams in Switzerland provide care to patients who are unable to use regular child and adolescent mental health services (i.e. inpatient and outpatients facilities). No study has considered patients' self-rated satisfaction alongside with staff members' perspectives on patient satisfaction. Thus, adopting a cross-sectional survey design, we collected patients' satisfaction using the Client Satisfaction Questionnaire (CSQ-8), rated by multiple informants (patients, foster carers in foster homes and professional caregivers from CT teams). Professional caregivers assessed clinical outcomes using the Health of the Nation Outcome Scale for Children and Adolescents. The results indicated that all informants were satisfied with the community treatment teams. The satisfaction scores were not correlated across informants; however, the alleviation of emotional symptoms was correlated with patients' satisfaction. This study indicated that the use of a combined approach including the views of service users and professionals gives important complementary information. Finally, in our sample, lower emotional symptoms were linked to enhanced patient satisfaction. This study demonstrated the importance of considering multiple perspectives to obtain the most accurate picture of patients' satisfaction. Second, focusing on the reduction of emotional symptoms might lead to a higher degree of patients' satisfaction.

Patients' satisfaction with community treatment: a pilot cross-sectional survey adopting multiple perspectives.

ACCESSIBLE SUMMARY: Patients' satisfaction is scarcely studied within the context of community treatment for adolescents. Thus, this study adopts a multiple perspective on patients' satisfaction (including service users as well as staff members). The results highlighted that all informants (patients, foster carers in foster homes and professional caregivers from community treatment teams) perceived the patients to be satisfied, with foster carers reporting the highest patient satisfaction rate. Considering the patient satisfaction rate from multiple perspectives provides complementary understandings. Clinical outcomes and, specifically, a reduction in emotional difficulties were related to patient's satisfaction, but only from the patients' perspective. ABSTRACT: Community treatment (CT) teams in Switzerland provide care to patients who are unable to use regular child and adolescent mental health services (i.e. inpatient and outpatients facilities). No study has considered patients' self-rated satisfaction alongside with staff members' perspectives on patient satisfaction. Thus, adopting a cross-sectional survey design, we collected patients' satisfaction using the Client Satisfaction Questionnaire (CSQ-8), rated by multiple informants (patients, foster carers in foster homes and professional caregivers from CT teams). Professional caregivers assessed clinical outcomes using the Health of the Nation Outcome Scale for Children and Adolescents. The results indicated that all informants were satisfied with the community treatment teams. The satisfaction scores were not correlated across informants; however, the alleviation of emotional symptoms was correlated with patients' satisfaction. This study indicated that the use of a combined approach including the views of service users and professionals gives important complementary information. Finally, in our sample, lower emotional symptoms were linked to enhanced patient satisfaction. This study demonstrated the importance of considering multiple perspectives to obtain the most accurate picture of patients' satisfaction. Second, focusing on the reduction of emotional symptoms might lead to a higher degree of patients' satisfaction.

How patient-centered do female physicians need to be? Analogue patients' satisfaction with male and female physicians' identical behaviors (Published online: 30 Aug 2014)

Previous research suggests that female physicians may not receive appropriate credit in patients' eyes for their patient-centered skills compared to their male counterparts. An experiment was conducted to determine whether a performance of higher (versus lower) verbal patient-centeredness would result in a greater difference in analogue patient satisfaction for male than female physicians. Two male and two female actors portrayed physicians speaking to a patient using high or low patient-centered scripts while not varying their nonverbal cues. One hundred ninety-two students served as analogue patients by assuming the patient role while watching one of the videos and rating their satisfaction and other evaluative responses to the physician. Greater verbal patient-centeredness had a stronger positive effect on satisfaction and evaluations for male than for female physicians. This pattern is consistent with the hypothesis that the different associations between patient-centeredness and patients' satisfaction for male versus female physicians occur because of the overlap between stereotypical female behavior and behaviors that comprise patient-centered medical care. If this is the case, high verbal patient-centered behavior by female physicians is not recognized as a marker of clinical competence, as it is for male physicians, but is rather seen as expected female behavior.

Exploring the path through which career adaptability increases job satisfaction and lowers work stress : the role of affect

The construct of career adaptability, or the ability to successfully manage one's career development and challenges, predicts several important outcomes; however, little is known about the mechanisms contributing to its positive effects. The present study investigated the impact of career adaptability on job satisfaction and work stress, as mediated by individuals' affective states. Using a representative sample of 1671 individuals employed in Switzerland we hypothesized that, over time, career adaptability amplifies job satisfaction and attenuates work stress, through higher positive affect and lower negative affect, respectively. The data resulted from the first three waves of a longitudinal project on professional paths conducted in Switzerland. For each wave, participants completed a survey. Results of the 3-wave cross-lagged longitudinal model show that employees with higher career adaptability at Time 1 indeed experienced at Time 3 higher job satisfaction and lower work stress than those with lower career adaptability. The effect of career adaptability on job satisfaction and work stress was accounted for by negative affect: Individuals higher on career adaptability experienced less negative affect, which led to lower levels of stress and higher levels of job satisfaction, beyond previous levels of job satisfaction and work stress. Overall results support the conception of career adaptability as a self-regulatory resource that may promote a virtuous cycle in which individuals' evaluations of their resources to cope with the environment (i.e., career adaptability) shape their affective states, which in turn influence the evaluations of their job.

Effects of business-to-business customer orientation, satisfaction and retention on firm profitability

The objective of this master’s thesis was to examine the effect of customer orientation on customer satisfaction and how customer satisfaction and customer retention contribute to firm profitability. Beside customer orientation, also other antecedents of customer satisfaction, i.e. service quality, flexibility, trust and commitment, were investigated as control variables. Literature review revealed several research gaps concerning research of the key concepts. These research calls were also answered. The empirical study focused on one case company, a telecommunication expert. The data for the empirical part was collected with web-based questionnaire from case company’s business customers in January-February 2008. Sample (N=95) produced 59 answers, thus the response rate of the survey was 62,1%. The data was analyzed by using statistical analysis program, SPSS. As a conclusion, the results indicate that customer orientation do not affect customer satisfaction directly, but through service quality, flexibility and trust. Moreover, customer satisfaction has positive impacts on commitment and intentions to stay as a customer in the future, but not on profitability. In the present study, only past purchase behavior, measured with customer database measure, is positively related to firm profitability.

Ammatti-identiteetin rakentuminen sairaanhoitajilla

Ammatti-identiteetti luo pohjan henkilön ammattitaidolle, oman, henkilökohtaisen ammatillisen osaamisen arvostamiselle sekä koko ammattikuvalle, sille millaisena työntekijänä jokainen itsensä näkee. Vahva ammatti-identiteetti aikaansaa positiivisen takaisinkytkennän, kun hyvin tehdyn työn seurauksena saadaan kannustavaa palautetta, mikä kasvattaa itsetuntoa, joka puolestaan luo positiivinen omakuvan, jonka seurauksena syntyy vahva ammatti-identiteetti. Tämän tutkimuksen tarkoituksena on selvittää millä tavoin ammatti-identiteetti rakentuu ja muotoutuu, ja millaisia ovat sitä muovaavat tekijät. Samalla pyritään selvittämään millainen merkitys ammatti-identiteetillä on työn suorittamiseen, työssä viihtymiseen sekä omaan näkemykseen itsestään tietyn alan ammattilaisena. Tutkimuksen kontekstina on terveydenhoitoala, ja empiriassa tutkitaan sairaanhoitajien ammatti-identiteettiä. Tutkimuksen perusteella näyttää siltä, että sairaanhoitajat arvostavat ammattiaan ja ammattitaitoaan huolimatta yhteiskunnallisesta aliarvostuksesta. Tämä tukee käsitystä sairaanhoitajien vahvasta ammatti-identiteetistä. Tutkimuksen tulokset osoittavat, että sairaanhoitajan ammatti-identiteetti on moniulotteinen ilmiö. Ammatti-identiteetti ei ole irrallinen henkilön persoonallisesta identiteetistä, vaan ne tukevat toinen toistaan.

Oxidative potential of particles in different occupational environments: a pilot study

The oxidative potential (OP) of particulate matter has been proposed as a toxicologically relevant metric. This concept is already frequently used for hazard characterization of ambient particles but it is still seldom applied in the occupational field. The objective of this study was to assess the OP in two different types of workplaces and to investigate the relationship between the OP and the physicochemical characteristics of the collected particles. At a toll station, at the entrance of a tunnel ('Tunnel' site), and at three different mechanical yards ('Depot' sites), we assessed particle mass (PM4 and PM2.5 and size distribution), number and surface area, organic and elemental carbon, polycyclic aromatic hydrocarbon (PAH), and four quinones as well as iron and copper concentration. The OP was determined directly on filters without extraction by using the dithiothreitol assay (DTT assay-OP(DTT)). The averaged mass concentration of respirable particles (PM4) at the Tunnel site was about twice the one at the Depot sites (173±103 and 90±36 µg m(-3), respectively), whereas the OP(DTT) was practically identical for all the sites (10.6±7.2 pmol DTT min(-1) μg(-1) at the Tunnel site; 10.4±4.6 pmol DTT min(-1) μg(-1) at the Depot sites). The OP(DTT) of PM4 was mostly present on the smallest PM2.5 fraction (OP(DTT) PM2.5: 10.2±8.1 pmol DTT min(-1) μg(-1); OP(DTT) PM4: 10.5±5.8 pmol DTT min(-1) μg(-1) for all sites), suggesting the presence of redox inactive components in the PM2.5-4 fraction. Although the reactivity was similar at the Tunnel and Depot sites irrespective of the metric chosen (OP(DTT) µg(-1) or OP(DTT) m(-3)), the chemicals associated with OP(DTT) were different between the two types of workplaces. The organic carbon, quinones, and/or metal content (Fe, Cu) were strongly associated with the DTT reactivity at the Tunnel site whereas only Fe and PAH were associated (positively and negatively, respectively) with this reactivity at the Depot sites. These results demonstrate the feasibility of measuring of the OP(DTT) in occupational environments and suggest that the particulate OP(DTT) is integrative of different physicochemical properties. This parameter could be a potentially useful exposure proxy for investigating particle exposure-related oxidative stress and its consequences. Further research is needed mostly to demonstrate the association of OP(DTT) with relevant oxidative endpoints in humans exposed to particles.

The effects of safety climate and trust on job satisfaction

Job satisfaction has been a frequently studied concept in organizational behavior. Past research has shown that trust in top management is an important factor influencing job satisfaction. To date, little attention has been paid to safety climate perceptions as a possible predictor of job satisfaction. In our study we investigated the direct and interactive effects of trust in top management and individual-level perceptions of safety climate in predicting job satisfaction. The findings of this study point to the importance of positive perceptions of safety climate on employees' job satisfaction when trust in top management is low.

Satisfaction with pregnancy and delivery services: The quality of maternity care services as experienced by women

Objective: The objective of this study was to investigate the opinions of women regarding the satisfaction about the quality of maternity care received. We hope to establish whether health care technology increases satisfaction or whether it actually interferes with the construction of personal satisfaction in the process of care. Design and setting: Information was gathered using the focus group technique. The area of study comprised the post-natal groups run as part of the Sexual and Reproductive Health Programme of the Catalan Health Authority. (Spain) Participants: Five focus groups were held between May 2006 and July 2007. Findings: Quality of care is a complex concept in which a number of independent core features can be identified. We have grouped these core features into three basic categories. Safety: the hospital and its technological facilities, and the technical expertise of health professionals. The other two main pillars of quality of care are the human dimension of the relationship between the carers and the patient, and finally the structural aspects that determine the context in which the heath care is provided. Key conclusions and implications for practice: The mothers of our study feel satisfied with healthcare technology and view it as a source of security; technology become indispensable features in order to reduce the anxiety provoked by the perceived lack of confidence in their ability as mothers. In this study, women, both during pregnancy and especially when giving birth, believe their feelings and values should be understood by professionals, from whom they seek empathy and a personal commitment, and not just information.

Satisfaction with pregnancy and delivery services: The quality of maternity care services as experienced by women

Objective: The objective of this study was to investigate the opinions of women regarding the satisfaction about the quality of maternity care received. We hope to establish whether health care technology increases satisfaction or whether it actually interferes with the construction of personal satisfaction in the process of care. Design and setting: Information was gathered using the focus group technique. The area of study comprised the post-natal groups run as part of the Sexual and Reproductive Health Programme of the Catalan Health Authority. (Spain) Participants: Five focus groups were held between May 2006 and July 2007. Findings: Quality of care is a complex concept in which a number of independent core features can be identified. We have grouped these core features into three basic categories. Safety: the hospital and its technological facilities, and the technical expertise of health professionals. The other two main pillars of quality of care are the human dimension of the relationship between the carers and the patient, and finally the structural aspects that determine the context in which the heath care is provided. Key conclusions and implications for practice: The mothers of our study feel satisfied with healthcare technology and view it as a source of security; technology become indispensable features in order to reduce the anxiety provoked by the perceived lack of confidence in their ability as mothers. In this study, women, both during pregnancy and especially when giving birth, believe their feelings and values should be understood by professionals, from whom they seek empathy and a personal commitment, and not just information.

Evaluation de l'impact des nouvelles Directives et recommandations architecturales des établissements médico-sociaux vaudois (DAEMS) sur la satisfaction des usagers

L'environnement construit contribue à influencer la santé des individus, selon l'Organisation Mondiale de la Santé. L'architecture des établissements médico-sociaux (EMS) peut, elle aussi, produire un impact sur le bien-être et la satisfaction des résident-e-s et des autres usagers. Dans le canton de Vaud, des normes architecturales de construction des EMS (les Directives et recommandations architecturales des établissements médico-sociaux, DAEMS) ont été créées en 2003 afin d'optimiser la conception des EMS par rapport aux besoins des usagers. Notre étude a pour but de vérifier si les EMS construits selon les DAEMS sont associés avec une satisfaction accrue des usagers par rapport aux EMS qui n'ont pas été construits selon ces directives. "Le but de la présente étude est de vérifier si le fait de construire les EMS selon les DAEMS est associé avec une plus grande satisfaction chez les usagers par rapport aux EMS qui n'ont pas été construits selon les DAEMS. Nous avons effectué une comparaison de la satisfaction auprès des trois-publics qui sont les principaux usagers des EMS, à savoir les résident-e-s, leurs proches de référence, et les professionnel-le-s en EMS. Trente EMS ont participé à l'étude, à savoir dix construits selon les DAEMS (EMS « DAEMS »), et vingt qui n'ont pas été construits selon les DAEMS (EMS « non-DAEMS »). Ce rapport a été défini pour garantir une bonne validité statistique des résultats"

Evaluation of occupational and patient dose in cerebral angiography procedures

Objective The present study was aimed at estimating the doses received by physicians and patients during cerebral angiography procedures in a public hospital of Recife, PE, Brazil. Materials and Methods The study sample included 158 adult patients, and during the procedures the following parameters were evaluated: exposure parameters (kV, mAs), number of acquired images, reference air kerma value (Ka,r) and air kerma-area product (PKA). Additionally, the physicians involved in the procedures were evaluated as for absorbed dose in the eyes, thyroid, chest, hands and feet. Results The results demonstrated that the doses to the patients' eyes region were relatively close to the threshold for cataract occurrence. As regards the physicians, the average effective dose was 2.6 µSv, and the highest effective dose recorded was 16 µSv. Conclusion Depending on the number of procedures, the doses received by the physicians may exceed the annual dose limit for the crystalline lenses (20 mSv) established by national and international standards. It is important to note that the high doses received by the physicians are due to the lack of radiation protection equipment and accessories, such as leaded curtains, screens and protective goggles.