A Research Report submitted to the School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the Degree of Master of Public Health.
October 2014, Johannesburg. / Background: Patient satisfaction with health services has widely been associated with increased health-seeking behaviour, improved clinical outcomes, and overall quality of health care. Research that has emerged from the developed world has steered the development of both satisfaction measures, as well as research into patient satisfaction at public health facilities. Despite the importance of patient satisfaction to positive health outcomes, few studies exist in the developing world that examine patient satisfaction levels with public health services. Even fewer exist in the field of public mental health services. This study aims to determine adult patients’ satisfaction with dimensions of care at a psychiatric out-patient clinic in Maseru, Lesotho.
Design: The study employs a quantitative cross–sectional study design, using interviewer administered paper-pencil questionnaires, which was adapted from the Charleston Psychiatric Out-patient Satisfaction Scale (CPOS) (Pellegrin, Stuart, Maree, Freuh, & Ballenger, 2001). The sample size for the present study was 271, with 194 females, who comprised the majority of the sample and 77 males. The adapted questionnaire elicited information on patient satisfaction within four specific dimensions of care namely, the staff-patient relationship, administrative services, responsiveness to patients’ treatment expectations and waiting times. In addition, a qualitative component including two open-ended questions gauged participants’ overall experience of satisfaction and self-reported recommendations on how to improve the clinic services.
Statistical analyses: Univariate analyses were conducted on patient socio-demographic variables and patient satisfaction scale. Subscales of patient satisfaction with the quality of services at the psychiatric facility were created. Bivariate analysis was conducted on
the socio-demographic variables, treatment history, referral source and subscales of the patient satisfaction scale using crosstabs and chi- square analysis. The two open-ended questions were analysed using thematic content analysis, hence identifying the themes and sub-themes.
Results: Univariate analyses showed that across all the 12 items measuring patient satisfaction, patients were mostly highly satisfied with the services. Chi-square analysis showed that age was significantly associated with administrative services (p=.014) and waiting time (p=0.05) and marginally significantly associated with responsiveness to patients’ treatment expectations (p=.063). Results from the open-ended component highlighted that most participants were dissatisfied with aspects pertaining to access to service, waiting times and adequacy of services.
Conclusion: Despite the seeming overall satisfaction expressed with the quality of psychiatric care on a scale of patient satisfaction, disaggregation of the results by subscales, as well as exploration of the open-ended responses from patients suggests that our understanding of patient satisfaction with the quality of mental health services may be limited by methodological issues, where patients felt more comfortable with the non-limiting nature of the open-ended section as opposed to the closed-ended nature of the quantitative section of the study tool. Furthermore, patients who are older may be more likely to show higher levels of satisfaction with care in a context where public health care is often challenging to access. This finding highlights a need for management and other stakeholders to pay more attention to the improvement of services for younger patients, who showed lower satisfaction levels with care. Future research employing mixed methods study designs is also suggested.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/17328 |
| Date | 26 March 2015 |
| Creators | Maphats'oe, Pulane |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf |
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