Predictors of patient satisfaction after cardiac pacemaker implantation or ICD implantation.

BACKGROUND AND AIM OF THE STUDY: The study aimed to identify predictors of satisfaction of patients receiving a cardiac pacemaker or an implantable cardioverter-defibrillator (ICD). METHODS: This was a cross-sectional study measuring patient satisfaction postdischarge by using a mailed questionnaire. Study participants included a random sample of hospitalized patients who had undergone implantation of a pacemaker or ICD in 30 hospitals in Germany. RESULTS: Data from 548 respondents (response rate 17.3%) were available for analyses. Logistic regression analysis revealed the following factors associated with satisfaction of inpatients (P < .05): outcome of treatment (odds ratio [OR] = 11.51, 95% confidence interval [CI] = 4.62-28.64), individualized medical care by physicians (OR = 5.04, 95% CI = 2.13-11.92), kindness of nurses (OR = 4.83, 95% CI = 1.52-15.42), and physicians (OR = 3.46, 95% CI = 1.03-11.65), organization of procedures and operations, respectively (OR = 4.45, 95% CI = 1.85-10.75) and thoroughness of the discharge instructions (OR = 2.69, 95% CI = 1.17-6.20). CONCLUSIONS: This study identified six predictors of satisfaction among pacemaker and ICD patients that can be addressed by healthcare providers to increase patients' evaluation of the hospitalization. Identified predictors of satisfaction are alterable by health care professionals and, thus, should be focused on to increase satisfaction ratings of patients who have undergone implantation of a pacemaker or ICD.

Effects of perceptions of care, medical advice, and hospital quality on patient satisfaction after primary total knee replacement: A cross-sectional study.

INTRODUCTION: The increase in the number of patients presenting with osteoarthritis in the past decade has led to a 32% increase in knee replacement surgeries designed to reduce restrictions on patient movement and improve their quality of life. Patient satisfaction is becoming an increasingly important indicator of quality of care. This study was designed to identify predictors of various service components in the treatment process and hospital key performance indicators significantly associated with patient satisfaction. MATERIALS AND METHODS: A multicenter cross-sectional study was conducted with 856 patients having their primary total knee replacements at 41 hospitals. Patient satisfaction was queried via a validated, multidimensional questionnaire mainly using a six-point scale. In addition to bivariate calculations, patient satisfaction was the dependent variable in a binary logistic regression model. RESULTS: The bivariate analysis showed a strong association between satisfaction and sex (male or female), the patients' health before admission, and the length of stay. The number of cases treated at each hospital did not reveal any impact on satisfaction. The multivariate analysis identified three predictors associated with overall satisfaction. The strongest factor was the treatment outcome and the weakest was the quality of food. It became apparent that the statutory procedure minimums were not being met. CONCLUSIONS: The relevant factors influencing patient satisfaction were partially the same as previous study results and allowed more detailed conclusions. The results provide suggestions across hospitals that could help health care providers better meet needs of patients after knee arthroplasties.

Determinants of patient satisfaction and their willingness to return after primary total hip replacement: a cross-sectional study.

BACKGROUND: Surveys of patient satisfaction and their willingness to return can be used for the optimization of processes, improving their quality, and increasing the satisfaction and loyalty in customers. This study looked at the factors significantly associated with patient satisfaction after primary total hip replacement (THR), and which affect the patients' willingness to return to the same hospital for future treatment, even when unrelated to their THR. METHODS: Data for the study was collected by written survey from 810 patients of 43 hospitals following their THR. Satisfaction and willingness to return were measured using a validated, multidimensional questionnaire, primarily based on six-point scales, which were then evaluated together with routine hospital data, according to bivariate and multivariate analyses. RESULTS: The bivariate analysis showed a strong correlation between satisfaction or willingness to return and the health condition before hospitalization as well as the perceived length of stay. In contrast, the patient's gender and the number of inpatient cases in a hospital with THR had no influence. The binary logistic regression analyses identified three predictors associated with overall satisfaction and seven predictors associated with willingness to return. The strongest factor for both dependent variables was the perceived length of stay, and the weakest factor for satisfaction was the treatment outcome. CONCLUSIONS: Overall, with all of the medical and service-related issues considered, high levels of satisfaction were reached. Despite the high satisfaction scores, probable causes for declining the willingness to return were identified. The results provide incentives for hospitals and medical professionals to attain a high satisfaction levels in their THR patients.

Patient satisfaction in urology: effects of hospital characteristics, demographic data and patients' perceptions of received care.

PURPOSE: To identify factors that are significantly associated with patient satisfaction in urology and to assess the extent to which satisfaction ratings might be related to hospital and patient characteristics. MATERIALS AND METHODS: Data used in this study were obtained from 1040 randomly selected urology patients discharged from nine hospitals who responded to a mailed survey. Bivariate and multivariate techniques were used to reveal relations between patient assessments of received care, hospital and patient characteristics. RESULTS: Bivariate analysis showed a strong association between satisfaction scores and length of stay, provider status, work load of nurses and hospital size, with weaker findings pertaining to type of hospital (teaching versus non-teaching) and patient demographics. The multivariate analysis identified nine vari­ables which are associated with overall satisfaction. Strong factors were treatment outcome, the interper­sonal manner of medical practitioners and nurses, as well as hotel aspects like accommodation and quality of food. Variables reflecting information receiving about the undergoing treatment were not found to have a significant influence on patient satisfaction. CONCLUSION: This study identified variables that are related to satisfaction in a urological setting and de­livers information about aspects of the hospital stay that are not perceived as relevant by patients. These findings support healthcare professionals with valuable information to meet needs and preferences of pa­tients in urology.

Analysis of factors associated with patient satisfaction in ophthalmology: the influence of demographic data, visit characteristics and perceptions of received care.

PURPOSE: To identify factors associated with satisfaction among patients receiving ophthalmic services and to indicate the intensity of this relationship. METHODS: The data used was obtained through a self-administered, post-visit questionnaire from randomly selected 507 patients treated in seven eye clinics in Germany. The instrument assessed satisfaction with several aspects of care and patient baseline and visit characteristics. Bivariate and multivariate techniques were used to reveal relations between indicators and overall satisfaction. RESULTS: Factor analysis yielded two factors, 'medical aspects of care' and 'performance of service', explaining 55% of total variance. Cronbach's α coefficient for both scales indicates acceptable internal consistency. Bivariate analysis showed strong relations between overall satisfaction and perceived care with weaker findings pertaining to visit characteristics. Not any of the demographic variables was associated with overall satisfaction. Perceived length of stay, intention to return to the clinic, and occurrence of complications were influential attributes on satisfaction ratings. The multivariate analysis identified seven factors associated with overall satisfaction including the treatment outcome (OR: 4.57), kindness of the nurses (OR: 5.27) and medical practitioners (OR: 2.23), room amenities (OR: 2.72), organization of procedures and operations (OR: 2.71), information about anaesthesia (OR: 1.95), and cleanliness (OR: 1.93). CONCLUSIONS: Factors associated with patient satisfaction in ophthalmology concern medical aspects like the organization of procedures and operations but also aspects that are not directly related to technical care, such as kindness of the nurses and cleanliness. Results show that patients' subjective experiences of received care and services relate more strongly and consistently to overall satisfaction than patient demographic data or visit characteristics. Revealed factors predicting patient satisfaction are alterable by health care managers. Therefore, focusing on these attributes represents an effective manner to enhance patient satisfaction in ophthalmology.

Determinants of patient satisfaction: a study among 39 hospitals in an in-patient setting in Germany.

OBJECTIVE: To identify key determinants of patient satisfaction. DESIGN: Data used were obtained through a self-administered, post-visit questionnaire by random sampling during the period of January 2009 to September 2009. SETTING: Thirty-nine hospitals in Germany. PARTICIPANTS: A total of 8,428 patients. MAIN OUTCOME MEASURE: Global patient satisfaction was measured by a single item question. Attributes of medical aspects of care were measured using 12 items, performance of service using 3 items and different dimensions of patient expectations using 12 items. Medical aspects of care and performance of service items were entered into logistic regression analysis to identify determinants of patient satisfaction. RESULTS: The results of the analysis showed that there are 10 determinants of global patient satisfaction. The outcome of treatment was overall, the most salient predictor followed by nursing kindness as the second most important component. Items reflecting information receiving about the undergoing treatment do not have a major influence on patient satisfaction. CONCLUSION: The analysis identified key determinants that should be altered first in order to improve global patient satisfaction. The results also indicate that some aspects of the hospital stay are not seen as relevant by patients and therefore are unrelated to satisfaction ratings. The findings suggest that variables measuring patients' perceptions of care are more important determinants of global patient satisfaction in comparison to demographics and visit characteristics. Results of the present study have implications for health providers aiming at improving the service quality and quality of care.

Factors associated with patient satisfaction in surgery: the role of patients' perceptions of received care, visit characteristics, and demographic variables.

BACKGROUND: Measures of satisfaction of surgical patients can be used to evaluate and redesign the process of care or to complement established procedures to improve quality of services. However, study findings regarding aspects of patient satisfaction are often inconsistent and depend on the setting. The primary goals of this research were to identify factors associated with satisfaction among patients in a surgical setting. MATERIALS AND METHODS: Data used in this study were obtained from randomly selected 2699 surgical patients discharged during January-December 2008 from 26 hospitals who responded to a mailed survey. The instrument assessed satisfaction regarding 23 items of perceived care, patient demographic, and visit characteristics. Bivariate and multivariate techniques were used to reveal relations between indicators and overall satisfaction. RESULTS: Bivariate statistics showed strong relations between overall satisfaction and perceived care with weaker findings pertaining to demographic and visit characteristics. The Multivariate logistic regression predicting overall satisfaction demonstrated that patients receiving surgical services predominantly have similar demands and priorities regardless of age and gender. The strongest factors were (P < 0.05) the interpersonal manner of medical practitioners and nurses, organization of operations, admittance, and discharge, as well as perceived length of stay. CONCLUSIONS: This study identified factors that are related to satisfaction of surgical patients and indicated the intensity of this relationship. These findings support health care providers and medical practitioners with valuable information to meet needs and preferences of patients receiving surgical services.

Disease-related conditions in elderly patients with multiple sclerosis.

Improved therapies have increased life expectancy in multiple sclerosis patients, resulting in a group of patients aged 65 years and older. Nowadays, health professionals are caring for more and more elderly multiple sclerosis patients, but little is known about the specific problems of these individuals. A review including relevant papers on problems reported by elderly multiple sclerosis patients revealed that the number of studies addressing this topic is still very limited. Most of these studies included only small patient sample sizes (27-169 patients), and were not originally designed to investigate elderly multiple sclerosis patients. Information on the clinical course of multiple sclerosis in elderly patients revealed proportions of 62-90% with relapsing-remitting courses. Main problems reported included disabilities in mobility and activities of daily living. The findings on depressive symptoms and suicidal tendencies were inconsistent. Specific recommendations for treatment of multiple sclerosis in elderly patients were not found. The studies highlight the problem that health professionals should be aware of an increasing group of elderly multiple sclerosis patients with many specific needs, avoiding nursing home admissions being a particular challenge. Furthermore, studies on the problems of elderly multiple sclerosis patients are required.

Sleep-related breathing disorders impair quality of life in haemodialysis recipients.

BACKGROUND: It is well known that the quality of life of haemodialysis recipients is often severely compromised. So far, the influence of sleep-related breathing disorders on the quality of life of patients receiving maintenance dialysis has not been evaluated. METHODS: Quality of life as assessed by the Medical Outcomes Study Short Form-36 (SF-36) and the Nottingham Health Profile Part 1 (NHP1) was determined in 33 patients (20 males, 13 females; median age 66 years (95% CI 22-82)) with end-stage renal disease treated with haemodialysis. Additionally, polygraphy with a validated eight-channel ambulatory recording unit was performed. RESULTS: Twenty-one patients (63.6%) had a clinically significant sleep-related breathing disorder with a median apnoea/hypopnoea index of 13.3 (6.3-78.1)/h and a median oxygen saturation during sleep of 92.5 (88-97)%. In three out of eight subjective measures of the SF-36 (vitality, social functioning and mental health) and in one out of six subjective measures of the NHP1 (emotional reactions), patients without sleep-related breathing disorders had a higher quality of life than patients with this disorder (P<0.05 each). Furthermore, the severity of the sleep-related breathing disorder as indicated by the apnoea/hypopnoea index significantly correlated with the following quality of life measures: physical functioning, social functioning, role limitation due to physical and emotional problems, general health and vitality (SF-36), and also with pain, sleep, social isolation and emotional reactions (NHP1) (P<0.05 each). CONCLUSIONS: We conclude that sleep-related breathing disorders independently influence the quality of life of patients receiving maintenance dialysis.