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The Patient Experience and Patient Satisfaction: Measurement of a Complex Dynamic
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Journal of Family and Economic Issues, 10 2 , — Hradil, S. Social inequality in Germany. Jang, J. Social capital accessibility of intermarrieds. Journal of Family and Economic Issues, 37 4 , — Methods: Sequential mixed-methods; triangulation of findings of questionnaire surveys and qualitative interviews. Results : Analysis of data from 41 questionnaires and 16 interviews demonstrate that relationships with staff and co-patients are sources of succour and angst, shaping experience of care.
Even where treatment is coercive, effort must be made to promote personalisation and flexibility and the non-authoritarian attitude valued by patients. After all, evidence based treatments can only be effective if patients engage. Further research should examine the process of care and outcome generation. It is axiomatic, in contemporary health care, that the views and experiences of people who use services are fundamental to quality. Translation of rhetoric to practice is challenging however within the complex health care environment. While clinicians aim to prioritise patient care, heavy workloads and bureaucratic demands can constrain patient contact.
Research demonstrates that patient experience is valuable not only intrinsically, but instrumentally; incorporating experience-based knowledge of patients in service development is sound business practice, supporting improvement in outcomes, reduction in costs, enhanced safety patient safety and provider satisfaction . Such circumstances are common in mental health care generally, and specifically in treatment of eating disorders ED such as anorexia nervosa AN . AN is a severe mental illness characterised by persistent restriction of energy intake, intense fear of weight gain and disturbance in body image .
Two sub-types - restricting AN-R and binge-purge AN-BP - may be diagnosed dependent on presentation, with a diagnosis of eating disorder not otherwise specified EDNOS used when criteria for specific conditions are not satisfied.
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The complexity of EDs and ego-syntonic nature of symptoms complicate treatment . Various nutritional, psychosocial and medical interventions may be employed alone or in combinations, dependent on service context, and patient needs. Practice guidelines promote community-based treatment whenever possible, but hospital admission may be required, particularly when patients are medically compromised .
Psychological well-being and health perception: predictors for past, present and future
Studies repeatedly highlight the value patients place on compassionate, respectful therapeutic engagement and feeling cared for as a whole person, with a life story, rather than a collection of symptoms . Studies of experience of inpatient treatment for AN demonstrate similar aspirations and the complex influence of treatment milieu on experience .
A secure, trusting therapeutic relationship and therapist attributes are recurrently identified as critical to engagement and satisfaction with services [14,]. Conversely perceptions that feelings are invalidated are associated with drop out [20,23,24]. While weight may be restored, psychological symptoms remain and repeated readmission is common [7,]. Aiming to contribute to the growing evidence base and inform service improvement locally we set out to describe the experiences of adults admitted to hospital for treatment of eating disorders.
Specific objectives were to assess the perceived helpfulness of various components of treatment, and clinician behaviours and attitudes valued by patients. We employed a sequential mixed-methods design. We first analysed responses to satisfaction questionnaires routinely offered to patients on discharge from a Specialist Eating Disorder Unit SEDU Text Box 1 , within a general psychiatric ward at a tertiary hospital in Australia. Results were explored in interviews with a consecutive sample of patients from the same unit.
Satisfaction questionnaire: routinely used in SEDU since , the questionnaire comprises a series of statements Table 1 regarding components of treatment. Respondents are invited to rate agreement using a four-point scale strongly disagree-strongly agree with space provided for free-text at each item. For the purpose of this study, Author 1 was provided with a service data base containing responses to questionnaires.
Overall, I was satisfied with the treatment I received while a patient on in the eating disorders unit. Qualitative interviews. Recruitment and interviews were undertaken by Authors 1 and 2 during Both are women aged over 35, trained as psychologists with PhDs. Author 2, a health services researcher experienced in mixed-methods research within mental health services, also has clinical experience treating patients with eating disorders. To maintain professional boundaries and privacy of participants, and encourage openness, Author 1 had no research-related contact with patients to whom she provided clinical care.
Consecutive sampling was employed with broad eligibility criteria: admission to SEDU for at least seven nights and assessed clinically as able to engage in interview. Patients meeting these criteria were approached, when nearing discharge, by a treating clinician who provided information about the study and sought permission to arrange a meeting with researchers. As appropriate dependent on availability and clinical contact , either Author 1 or 2 met potential participants and provided comprehensive information about the study.
Emphasis was placed on the voluntary nature of participation, confidentiality of data, anonymous reporting and independence of research from clinical decisions. Interviews were completed in private spaces on SEDU not more than two days before discharge. Interviews were planned for this time because we anticipated potential participants would be medically and affectively stable, have experienced the full treatment program including progression from involuntary treatment; our anticipation was that patients would be in a position to reflect critically on experiences.
We were also concerned to minimise risk of loss to follow-up once patients returned to the community. A conversational approach was adopted with participants encouraged to speak frankly. Prompts were used to elicit views about structure and process of care and perceived helpfulness of interventions. Questioning was informed by ongoing analysis of questionnaire and interview data. Data were saturated at the conclusion of interviews; that is redundant data were generated and varying perspectives had been gathered.
Interviews which averaged 30 minutes were audio recorded and transcribed verbatim. Questionnaire data were analysed in three stages. Next, free-text responses were analysed using an adapted framework approach . Developed in the s, the method is extensively used in applied health research. Data within and between cells were then examined using a constant comparative process enabling identification of patterns and divergences.
Similar comments were grouped in new cells and labelled descriptively. Performed the experiments: GC SF. Analyzed the data: GC SF. Browse Subject Areas? Click through the PLOS taxonomy to find articles in your field. Abstract Although ageing people could benefit from healthy diet and physical activity to maintain health and quality of life, further understandings of the diet- and physical activity-related mechanisms that may cause changes in health and quality of life perception are necessary.
Introduction In light of the increasing life expectancy of western citizens, several organizations and government agencies have endorsed the benefits of a healthy lifestyle and healthy diet [ 1 , 2 ] In fact, the combination of insufficient physical activity and high-energy intakes is responsible for the actual high incidence of overweight and obesity, which is linked to several diseases [ 3 ].
Anthropometric evaluation With participants wearing light underwear and no shoes, standing height to the nearest 0. Questionnaires Assessments took place individually under the supervision of an investigator, who specified that there were no right or wrong responses. Body Image. Exercise Dependence. Eating Attitudes. Health Survey. Statistical analysis Data were analysed using the Statistical Package for the Social Science, version Results Activity level, age and gender influence on the study variables Table 1 reports the anthropometric characteristics, regular use of medications, number of diseases, and education background of the participants.
Download: PPT. Table 1. Anthropometric characteristics, weight category, number of medications and diseases, and educational background of participants. Table 2. Table 3. Table 4. Table 5. Fig 1.
Discussion The present study aimed at furthering our understanding of i the relationship between type of physical activity habits and perceived health-related quality of life in aging and ii the potential mechanisms underlying this relationship in the mental and physical domains. Health-related quality of life, body mass and image, eating and exercise attitudes in aging: commonalities and differences between athletes, physically actives, or inactives Consistent with the literature showing an overwhelming positive association of an active lifestyle with the reduction of preventable chronic diseases and increased self-perceived quality of life in older individuals [ 20 ], our results showed that being physically active is associated to reduced occurrence of pathologies and number of medication and higher perceived physical and mental health.
A three-path mediation link between activity habits, body mass and image, and mental health The novelty of the study is that beyond the general finding that senior athletes perceive better physical and mental health than sedentary co-aged individuals, there may be more direct or indirect paths linking a prolonged history of sport participation to the perception of a good health depending on the considered health domains. Conclusions This study revealed the crucial role of an active lifestyle and habitual sport participation in determining physical and mental health perception at advanced age.
Supporting Information. S1 Dataset. Anthropometric and questionnaires data. S1 Appendix. English version of the questionnaires. S2 Appendix. Italian version of the questionnaires. References 1. European Commission. World Health Organization.
Health-Related Quality of Life & Well-Being | Healthy People
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Hogan S, Warren L. Dealing with complexity in research processes and findings: how do older women negotiate and challenge images of aging? J Women Aging. Looking age-appropriate while growing old gracefully: A qualitative study of ageing and body image among older adults. J Health Psychol. Assessment of body image.