Ng Sau Kwan. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2004. / Includes bibliographical references (leaves 107-127). / Abstracts in English and Chinese. / ABSTRACT --- p.ii / ACKNOWLEDGEMENTS --- p.vi / TABLE OF CONTENTS --- p.vii / LIST OF TABLES --- p.ix / LIST OF APPENDICES --- p.x / Chapter Chapter 1: --- INTRODUCTION / Background of the study --- p.1 / Significance of the study --- p.3 / Chapter Chapter 2: --- LITERATURE REVIEW / Introduction --- p.6 / Search Strategy --- p.6 / Overview of the Concepts of Pain --- p.7 / Types of Pain --- p.8 / Nature of Postoperative Pain --- p.9 / Effects of Pain --- p.9 / Factors Influencing Pain Management Outcomes / Undermanaged Postoperative Pain --- p.11 / Assessing Pain in Postoperative Patients --- p.14 / Pain Relief and Patient Satisfaction --- p.16 / Health Locus of Control --- p.20 / Health Care Professionals' Attitudes --- p.22 / Barriers to Postoperative Pain Relief --- p.24 / Psychosocial Factors Influencing Patient Satisfaction --- p.26 / Nursing and Quality Assurance of Pain Management --- p.29 / Pain Management Strategies / Organization of an Acute Pain Service --- p.32 / Pharmacological Pain Management --- p.35 / Nonpharmacological Pain Management --- p.37 / Summary of Literature Review --- p.38 / Chapter Chapter 3: --- METHOD / Introduction --- p.41 / Aim and objectives of the study --- p.41 / Research Questions --- p.42 / Research Hypotheses --- p.43 / Operational Definitions --- p.43 / Research Design --- p.44 / Settings --- p.45 / Sample --- p.46 / Instruments --- p.47 / The Modified American Pain Society Patient Outcome Questionnaire (APS-POQ-Modified) --- p.48 / The State Scale of State-Trait Anxiety Inventory (STAI) --- p.50 / The Multidimensional Health Locus of Control Form C Scale (MHLC) --- p.53 / The Modified Patient Satisfaction Questionnaire (PSQ-Modified) --- p.54 / Demographic Data Form --- p.55 / Translation and Content Validity of the Instruments --- p.55 / Pilot Study --- p.57 / Data Collection Procedures --- p.60 / Data Analysis / Effect Size and Power of the Study --- p.62 / Ethical Considerations --- p.64 / Conclusion --- p.65 / Chapter Chapter 4: --- RESULTS / Introduction --- p.66 / Reliability of the Instruments --- p.67 / Demographic Characteristics / Medical Characteristics --- p.70 / Physical and Psychosocial Characteristics of Pain / Pain intensity and pain interference --- p.72 / Beliefs about pain --- p.73 / State anxiety --- p.73 / Health locus of control --- p.73 / Patient satisfaction --- p.75 / Responses to Modified Patient Outcome Questionnaire --- p.75 / Comparisons of Patient Satisfaction Ratings with Demographic / Characteristics --- p.77 / Correlates of Patient Satisfaction --- p.78 / Predictors of Patient Satisfaction --- p.80 / Conclusion --- p.82 / Chapter Chapter 5: --- DISCUSSION / Introduction --- p.84 / Demographic Characteristics --- p.84 / Effect Size and Power of the Study --- p.85 / Patient Satisfaction with Pain Management and Pain Intensity --- p.86 / Multidimensional Health Locus of Control --- p.90 / Beliefs or Misconceptions about pain --- p.94 / Education on Pain Management --- p.98 / Conclusion --- p.101 / Chapter Chapter 6: --- "LIMITATIONS, IMPLICATIONS, RECOMMENDATIONS AND CONCLUSION" / Introduction --- p.102 / LIMITATIONS OF THE STUDY --- p.102 / IMPLICATIONS FOR NURSING PRACTICE --- p.106 / RECOMMENDATIONS FOR FUTURE PRACTICE / AND RESEARCH --- p.110 / CONCLUSION --- p.113 / REFERENCES --- p.115

Source: Dissertation Abstracts International, Volume: 56-12, Section: B, page: 6692. Supervisor: Lu Ann Aday. Includes bibliographical references (leaves 164-167).

The study investigated how patients in the general wards of the Avenues Clinic perceive the nursing care they received. The study objectives were to identify how nurses in the general wards of the Avenues Clinic respond to patients' needs and if the nursing care received from the nurses matched patients' expectations. The study further sought to determine if patients would return to use Avenues Clinic nursing services and recommend services to family and friends. Data was drawn from 87 respondents by randomly distributing 100 questionnaires to three thirty-four bedded general wards of the Avenues Clinic. Findings of the study indicated that the majority of patients who received nursing care that was in line with their expectations would also return to use Avenues Clinic nursing services as well as recommend the services to family and friends. The theme "optimal care" was used to consolidate patient satisfiers while "suboptimal care" was used to describe patient dissatisfiers. / Health Studies / (M.A.(Health Studies ))

The study investigated how patients in the general wards of the Avenues Clinic perceive the nursing care they received. The study objectives were to identify how nurses in the general wards of the Avenues Clinic respond to patients' needs and if the nursing care received from the nurses matched patients' expectations. The study further sought to determine if patients would return to use Avenues Clinic nursing services and recommend services to family and friends. Data was drawn from 87 respondents by randomly distributing 100 questionnaires to three thirty-four bedded general wards of the Avenues Clinic. Findings of the study indicated that the majority of patients who received nursing care that was in line with their expectations would also return to use Avenues Clinic nursing services as well as recommend the services to family and friends. The theme "optimal care" was used to consolidate patient satisfiers while "suboptimal care" was used to describe patient dissatisfiers. / Health Studies / (M.A.(Health Studies ))

Patient satisfaction dimensions have a wide ranging and significant impact on organizational performance in the healthcare industry. In addition, the Centers for Medicare and Medicaid Services Hospital Value Based Purchasing (HVBP) Program links patient satisfaction to Medicare reimbursement, putting millions of dollars at risk for health systems. A gap in the literature exists in the exploration of how a patient's experience in the emergency department affects their satisfaction with inpatient services. In a multiple regression analysis, the relationship between HVBP Patient Experience of Care and hospital level factors including emergency department wait times are explored. Results indicate a statistically significant relationship between hospital level factors and standardized measure of patient satisfaction with a moderate adjusted effect size (p= <.0001, R2 adjusted= 0.184). Emergency department wait times post physician admit orders were most salient in predicting patient satisfaction scores (rs2= 0.434, β= -0.334, p= <.001). Recommendations to improve emergency department wait times include focusing on key decision points and implementation of electronic systems to support the movement of admitted patients out of the emergency department as quickly as possible.

Forskning visar på att patienter önskar kontinuitet, då de upplever att det bidrar till känslan av trygghet och närhet. Det ger sjuksköterskan möjlighet att lära känna personen och en möjlighet att bättre följa upp gjorda åtgärder. Syfte Syftet med denna studie var att beskriva vilka faktorer som har samband med patientens upplevelse av kontinuitet i vården. Metod Studien har genomförts som en litteraturstudie. Resultat Resultatet visade att det var viktigt för kontinuiteten att de fick träffa en sjuksköterska som de kände sedan tidigare och att det var samma sjuksköterska vid alla vårdtillfällen. Det var även viktigt att sjuksköterskan de träffade var uppdaterad på deras medicinska historia. En viktig faktor som höjde kontinuiteten var om patienten hade en kronisk sjukdom, då de patienterna oftare kräver regelbunden uppföljning med fler besök hos vården. Patienterna upplevde större kontinuitet om vården utfördes av sjuksköterska istället för av andra vårdgivare Sjuksköterskorna var mer anpassningsbara, flexibla och tog sig mer tid med patienten. Slutsats Studien visar att kontinuitet är något som patienter upplever som viktigt när de möter vården men det saknas forskning om hur vården ska organiseras, för att kontinuiteten ska upplevas bättre ur ett patientperspektiv, balanserat mot organisationens behov av att spara tid och pengar. / Research shows that patients wants continuity, as they feel it adds to the feeling of security and closeness That it gives the nurse the opportunity to get to know the person and an opportunity to better follow up actions. Aim The aim of this study was to investigate the factors that influence patient perception of continuity of care. Method This study was conducted as a literature review. Result The results showed that it was important for the continuity that they got to meet a nurse they knew from before, and it was the same nurse at every appointment. It was also important that who they met, was up to date on their medical history. An important factor that increased continuity was if the patient has a chronic disease, which increases the need to require regular follow-up with more visits to health care. Patients experienced greater flexibility of care performed by a nurse instead of a doctor, the nurses took more time with the patient and that it was more effective. Conclusion The study shows that continuity is important when patients recieve care, but there is no research about how care should be organized, for continuity to be perceived better from a patient perspective, balanced against the needs of the organization to save time and money.

There are theoretical and methodological difficulties in measuring the concepts of quality of care and patient satisfaction, and the conditions associated with these concepts. A theoretical framework of patient satisfaction and a theoretical model of quality of care have been used as the theoretical basis in this thesis. Aim. The overall aim was to describe and explore relationships between person-related conditions, external objective care conditions, patients’ perceptions of quality of care, and patient satisfaction with care in hospital. Methods. Quantitative and qualitative methods were used. In the quantitative study (I-III), 528 patients (83.7%) from eight medical, three surgical and one mixed medical/surgical ward in five hospitals in Norway agreed to participate (10% of total discharges). Data collection was conducted using a questionnaire comprising four instruments: Quality from Patients’ Perspective (QPP); Sense of Coherence scale (SOC); Big Five personality traits – the Single-Item Measures of Personality (SIMP); and Emotional Stress Reaction Questionnaire (ESRQ). In addition, questions regarding socio-demographic data and health conditions were asked, and data from ward statistics were included. Multivariate statistical analysis was carried out (I-III). In the qualitative study 22 informants were interviewed (IV). The interviews were analysed by conventional content analysis. Main findings. Patients’ perceptions of quality of care and patient satisfaction ranged from lower to higher depending on whether all patients or groups of patients were studied. The combination of person-related and external objective care conditions explained 55% of patients’ perceptions of quality of care (I). 54.7% of the variance in patient satisfaction was explained, and the person-related conditions had the strongest impact, explaining 51.7% (II). Three clusters of patients were identified regarding their scores on patient satisfaction and patients’ perceptions of quality of care (III). One group consisted of patients who were most satisfied and had the best perceptions of quality of care, a second group of patients who were less satisfied and had better perceptions, and a third group of patients who were less satisfied and had the worst perceptions. The qualitative study revealed four categories of importance for patients’ satisfaction: desire to regain health, need to be met in a professional way as a unique person, perspective on life, and need to have balance between privacy and companionship (IV). Conclusions. Patients’ perceptions of quality of care and patient satisfaction are two different concepts. The person-related conditions seem to be the strongest predictors of patients’ perceptions of quality of care and patient satisfaction. Registered nurses need to be aware of this when planning and conducting nursing care. There is a need of guidelines for handling over‑occupancy, and of procedures for emergency admissions on the wards. The number of registered nurses on the wards needs to be considered. Healthcare personnel must do their utmost to provide the patients with person‑centred care.

Thesis (M.Tech.:Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2006 x, 65 leaves, Annexures A-H / Patient satisfaction is an important, desired measure of quality of care and has a significant influence on the perceived quality of care and outcome of treatment, and for this reason, it holds great value to the treating clinician. Satisfied patients are more likely to comply with treatment instructions and advice, remain with their service provider and refer others. Dissatisfaction, in the event of an unfavourable outcome, can result in legal action and complaints to regulatory bodies. Studies have indicated a high level of satisfaction with chiropractic care; however, none have been in a student clinic setting even in view of the suggested importance in the literature. In view of this significance and lack of understanding of the patients’ satisfaction / dissatisfaction in the history of DIT’s clinic operation the question remains as to what extent the students at the DIT Chiropractic Day Clinic satisfy their patients. This study evaluated the patient satisfaction at the DIT Chiropractic Day Clinic in order to establish a baseline for future comparison. Cronbach’s alpha scores were used to determine questionnaire reliability in a South African student context.

Thesis (MBA)--Stellenbosch University, 2008. / ENGLISH ABSTRACT: Optometric practices, as every other organisation, are becoming more aware that the ability to address your patients' needs is the latest challenge and secret to future success. The purpose of this study is to determine the gap between the patients' expectations and their perceptions of the services rendered in the optometric practice. When the patients' perceptions of the service received meets or exceeds their expectations, the patient will be satisfied and will be encouraged to visit the practice again, increasing the long-term profitability of the practice. Most patients lack the knowledge to evaluate the quality of optometric services. As a result, they rely on the integrity and competence of the service provider. Service excellence is a combination of service promptness, quality, and design with the perception of value for money. Reliability is the most important of the five dimensions in determining patient evaluations of service quality. Since the tangible attributes are often the only element of a service that can be evaluated prior to service delivery, managers should pay a lot of attention to this dimension in order to reflect a positive image. As patients become more informed, practices should continuously research and update their strategies for the delivery of quality service. Not only do practices need to understand the current expectations of their patients, but also the future expectations desired. A key issue for future research concerns the relationship between internal service quality and external customer satisfaction as well as employee service orientation, and external service quality. / AFRIKAANSE OPSOMMING: Oogkundige praktyke, soos elke ander organisasie, raak toenemend bewus dat die nuutste uitdaging en geheim tot toekomstige sukses afhang van die vermoë om pasiente se behoeftes aan te spreek. Die doelwit van hierdie studie is om die gapings te bepaal tussen die pasiënt se verwagtinge en hul persepsies van die dienste gelewer in die oogkundige praktyk. Indien die pasiënte se persepsies van die gelewerde diens, hulle verwagtinge aanspreek of oorskry, sal dit pasiënt tevredenheid bevorder en die pasiënt aanspoor om die praktyk weer te besoek, en derhalwe die langtermyn winsgewendheid van die praktyk bevorder. Die meeste pasiënte beskik oor gebrekkige kennis om die kwaliteit van die optometriese dienste te evalueer. Gevolglik vertrou hulle op die integriteit en vaardigheid van die diensverskaffer. Uitstekende dienslewering kombineer stiptelikheid, kwaliteit, en die samestelling van die diens met die persepsie van waarde vir geld. Betroubaarheid is die belangrikste van die vyf dimensies om die pasiënt se evaluasie van die kwaliteit van diens te bepaal. Aangesien die tasbare eienskappe dikwels die enigste element van die diens is wat voortydig deur die pasient evalueer kan word, behoort bestuurders baie aandag daaraan te bestee ten einde 'n positiewe beeld te weerspieël. Aangesien pasiënte toenemend meer ingelig is, behoort praktyke voortdurende navorsing te doen om hulle strategies op te skerp vir die lewering van kwaliteit diens. Praktyke moet nie net slegs die huidige verwagtinge van hul pasiënte verstaan nie, maar ook die verlangde toekomsverwagtinge. 'n Sleutelaspek vir toekomstige navorsing is die verhouding tussen interne dienskwaliteit en eksterne kliëntbevrediging, asook die werknemer se oriëntasie tot dienslewering en eksterne dienskwaliteit.

Sambandet mellan patienters förväntningar inför axeloperation och i vilken utsträckning dessa påverkar den upplevda nöjdheten är inte entydigt. Positiva förväntningar är viktiga samtidigt som orealistiskt höga förväntningar kan ge lägre patientnöjdhet. Uppföljning utifrån individens upplevelse är viktig för att följa resultat och öka patientnöjdheten i en personcentrerad vård. Syftet med denna studie var att redogöra för en grupp axelopererade patienters mål inför operation, måluppfyllelse efter ett år och undersöka eventuella samband mellan olika förväntningar och grad av måluppfyllelse. Syftet var också att beskriva upplevd livskvalitet före och ett år efter operation, korrelera skattad livskvalitet och måluppfyllelse efter ett år samt undersöka eventuella skillnader i skattade värden beroende på bakgrundsfaktorer. Metoden var en  korrelerande prospektiv registerbaserad studie. Huvudresultatet visade hög grad av patientnöjdhet både för skattad livskvalitet och uppfyllelse av personligt mål, sambandet mellan dessa värden var starkt. Smärtfrihet var den vanligaste förhoppningen. Signifikant samband mellan olika förväntningar och uppnått mål sågs i grupperna ¨återgå till arbete¨ och ¨smärtfri nattetid¨. Kvinnor skattade signifikant lägre värden än män före operation men ingen signifikant skillnad kan ses vid ettårsuppföljningen. Slutsatsen var att undersökningsgruppen inför operation hade höga förväntningar och att dessa i stor utsträckning uppnåtts. Likaså sågs tydlig ökning i skattad livskvalitet. Minskad smärta/smärtfrihet var tydligt den viktigaste förväntan inför operation. Denna utvärdering av patientens upplevelse av måluppfyllelse och livskvalitet kan ge återkoppling i arbetet för att stärka och utveckla en personcentrerad vård. / The correlation between the expectations before shoulder surgery and to which extent they affect patient satisfaction is not unambiguous. Positive expectations are important whilst unrealistic expectations could lead to reduced patient satisfaction. Follow up based on the experiences of the individual is important to follow results and increase patient satisfaction in a person centred care. The aim of this study was to narrate the preoperative goals and the fulfilment of these goals after one year for a group of patients who had undergone shoulder surgery and to investigate the eventual relationship between different expectations and degree of goal fulfilment. The aim was also to describe the perceived life quality before and one year after surgery, to correlate perceived life quality and goal fulfilment after one year and to examine eventual differences in assessed values due to demographic factors. The method was a correlative prospective register based study. The main result showed high degree of patient satisfaction for both assessed life quality and fulfilment of personal expectations, the correlation between these values where strong. Relief of pain was the most common expectation. Significant correlation between expectations and goal assessment where seen in the groups ¨return to work¨ and ¨relief of nocturnal pain¨. Women assessed significant lower values than men before operation but no significant differences where seen at the follow-up after one year. The conclusion was that the study population had high preoperative expectations and that these where fulfilled to a great extent. An explicit increase in perceived life quality was also seen. Relief or reduction of pain was clearly the most important expectation before surgery. This evaluation of patients’ sense of goal fulfilment and perceived life quality might give feed back in the work to strengthen and generate a person centred approach.