Complaints and Satisfaction of Patients in Psychiatric Hospitals: The Case of Israel.
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ABSTRACT:
SUBMITTER: Semyonov-Tal K
PROVIDER: S-EPMC8205344 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundCultural competence (CC) in health systems is the ability to provide care to patients with different values, beliefs and behaviors, and to match the care to their social, cultural and linguistic needs. In 2011, the Director-General of Israel's Ministry of Health issued a cultural competence directive to health care providers that sought to minimize health inequalities caused by cultural and linguistic gaps. This study assesses the status of organizational CC in Israeli general hospitals in the wake of the 2011 directive.MethodOrganizational CC was assessed using a 75-item structured questionnaire based on the 2011 directive and on international standards. Data were gathered via interviews conducted between December 2012 and February 2014. 35 of Israel's 36 general hospitals participated in the study, for a response rate of 97%. A composite CC score was calculated for each hospital as the average of the 75 items in the questionnaire.ResultsThe average composite score of all the hospitals was low to moderate (2.3 on a scale of 0-4), the median score was 2.4, and the range of composite scores was large, 0.7-3.2. The interquartile range was [1.94, 2.57]. Hospital CC is positively associated with non-private ownership status and location in the southern or central districts. Still, these differences are not statistically significant and immutable hospital characteristics such as ownership status and location account for only 21% of the inter-hospital variation in CC. This suggests that hospital leaders have significant discretion in the priority to be given to CC. Dimensions of CC with relatively low average scores include hospital connections with the community (1.28), staff training on CC (1.35), oral translation (i.e. interpreting) during treatment (1.62), and CC adaptation of human resources recruitment and evaluation (1.64). These areas appear to be particularly in need of improvement.ConclusionThe study findings suggest that hospitals and policy-makers can take significant steps to improve CC; these include setting more concrete and measurable implementation guidelines. We conclude with suggestions for policy and practices to improve cultural competence in the health system.
| S-EPMC6241030 | biostudies-literature
Project description:BackgroundRandomised controlled trials suggest that family therapy has a positive effect on the course of depression, schizophrenia and anorexia nervosa. However, it is largely unknown whether a positive link also exists between caregiver involvement and patient outcome in everyday psychiatric hospital care, using information reported directly from patients, i.e. patient-reported experience measures (PREM), and their caregivers. The objective of this study is to examine whether caregiver-reported involvement is associated with PREM regarding patient improvement and overall satisfaction with care.MethodsUsing data from the National Survey of Psychiatric Patient Experiences 2018, we conducted a nationwide cross-sectional study in Danish psychiatric hospitals including patients and their caregivers who had been in contact with the hospital (n = 940 patients, n = 1008 caregivers). A unique patient identifier on the two distinct questionnaires for the patient and their caregiver enabled unambiguous linkage of data. In relation to PREM, five aspects of caregiver involvement were analysed using logistic regression with adjustment for patient age, sex and diagnosis.ResultsWe consistently find that high caregiver-reported involvement is statistically significantly associated with high patient-reported improvement and overall satisfaction with care with odds ratios (OR) ranging from 1.69 (95% confidence interval (CI) 0.95-2.99) to 4.09 (95% CI 2.48-6.76). This applies to the following aspects of caregiver-reported involvement: support for the patient-caregiver relationship, caregiver information, consideration for caregiver experiences and the involvement of caregivers in decision making. No statistically significant association is observed regarding whether caregivers talk to the staff about their expectations for the hospital contact.ConclusionThis nationwide study implies that caregiver involvement focusing on the patient-caregiver relationship is positively associated with patient improvement and overall satisfaction with care in everyday psychiatric hospital care.
| S-EPMC8042926 | biostudies-literature
Project description:ImportanceThe association of Lyme neuroborreliosis with the development of psychiatric disease is unknown and remains a subject of debate.ObjectiveTo investigate the risk of psychiatric disease, the percentage of psychiatric hospital inpatient and outpatient contacts, and the receipt of prescribed psychiatric medications among patients with Lyme neuroborreliosis compared with individuals in a matched comparison cohort.Design, setting, and participantsThis nationwide population-based matched cohort study included all residents of Denmark who received a positive result on an intrathecal antibody index test for Borrelia burgdorferi (patient cohort) between January 1, 1995, and December 31, 2015. Patients were matched by age and sex to a comparison cohort of individuals without Lyme neuroborreliosis from the general population of Denmark. Data were analyzed from February 2019 to March 2020.ExposuresDiagnosis of Lyme neuroborreliosis, defined as a positive result on an intrathecal antibody index test for B burgdorferi.Main outcomes and measuresThe 0- to 15-year hazard ratios for the assignment of psychiatric diagnostic codes, the difference in the percentage of psychiatric inpatient and outpatient hospital contacts, and the difference in the percentage of prescribed psychiatric medications received among the patient cohort vs the comparison cohort.ResultsAmong 2897 patients with Lyme neuroborreliosis (1646 men [56.8%]) and 28 970 individuals in the matched comparison cohort (16 460 men [56.8%]), the median age was 45.7 years (interquartile range [IQR], 11.5-62.0 years) for both groups. The risk of a psychiatric disease diagnosis and the percentage of hospital contacts for psychiatric disease were not higher among patients with Lyme neuroborreliosis compared with individuals in the comparison cohort. A higher percentage of patients with Lyme neuroborreliosis compared with individuals in the comparison cohort received anxiolytic (7.2% vs 4.7%; difference, 2.6%; 95% CI, 1.6%-3.5%), hypnotic and sedative (11.0% vs 5.3%; difference, 5.7%; 95% CI, 4.5%-6.8%), and antidepressant (11.4% vs 6.0%; difference, 5.4%; 95% CI, 4.3%-6.6%) medications within the first year after diagnosis, after which the receipt of psychiatric medication returned to the same level as the comparison cohort.Conclusions and relevanceIn this population-based matched cohort study, patients with Lyme neuroborreliosis did not have an increased risk of developing psychiatric diseases that required hospital care or treatment with prescription medication. The increased receipt of psychiatric medication among patients with Lyme neuroborreliosis within the first year after diagnosis, but not thereafter, suggests that most symptoms associated with the diagnosis subside within a short period.
| S-EPMC7542530 | biostudies-literature
Project description:The goal of this study was to explore antipsychotic medication prescribing practices in a sample of 86,034 patients discharged from state psychiatric inpatient hospitals and to find the prevalence of patients discharged with no antipsychotic medications, on antipsychotic monotherapy, and on antipsychotic polypharmacy. For patients discharged on antipsychotic polypharmacy, the study explored the adjusted rates of antipsychotic polypharmacy, the reasons patients were discharged on antipsychotic polypharmacy, the proportion of antipsychotic polypharmacy by mental health disorder, and the characteristics associated with being discharged on antipsychotic polypharmacy.This cross-sectional study analyzed all discharges for adult patients (18 to 64?y of age) from state psychiatric inpatient hospitals between January 1 and December 31, 2011. The relationship among variables was explored using ?, t test, and analysis of variance. Logistic regression was used to determine predictors of antipsychotic polypharmacy.The prevalence of antipsychotic polypharmacy was 12%. Of the discharged patients receiving at least 1 antipsychotic medication (adjusted rate), 18% were on antipsychotic polypharmacy. The strongest predictors of antipsychotic polypharmacy being prescribed were having a diagnosis of schizophrenia and a length of stay of 90 days or more. Patients were prescribed antipsychotic polypharmacy primarily to reduce their symptoms.Antipsychotic polypharmacy continues at a high enough rate to affect nearly 10,000 patients with a diagnosis of schizophrenia each year in state psychiatric inpatient hospitals. Further analysis of the clinical presentation of these patients may highlight particular aspects of the illness and its previous treatment that are contributing to practices outside the best-practice guideline. An increased understanding of trend data, patient characteristics, and national benchmarks provides an opportunity for decision-making that is sensitive to the patient's needs and cognizant of the hospital's accomplishments in adopting best practices.
| S-EPMC4956725 | biostudies-literature
Project description:BackgroundResearch in recent years has demonstrated that the use of coercive measures such as seclusion and restraint differs very much between hospitals within a country. In 2015, a central register for all coercive measures in the German federal state of Baden-Wuerttemberg has been established for 32 hospitals treating involuntary patients. The objective of the present study was to identify factors that determine the differences between these hospitals.MethodsData on coercive measures and diagnoses from the central register in 2015-2017 were linked with structural data of the 32 hospitals and their supply areas.ResultsOn average, coercive measures were applied in 6.7% of cases (SD = 2.8%; Min-Max = 0.35-12.0%). The proportion of affected cases was significantly correlated with the proportion of involuntary patients (r = 0.56), the proportion of cases with affective or neurotic, stress-related and somatoform disorders (r = -0.42), number of hospital beds (r = 0.44), a sheltered home associated with the hospital (r = 0.43) and number of addiction counseling centers per 100,000 inhabitants in the service area (r = -0.39). The final regression model only included the proportion of involuntary cases as a significant predictor (standardized beta = 0.55, adjusted R 2 = 0.27).ConclusionsThe predominating part of the considerable variance observed between hospitals could not be explained by structural variables. The proportion of involuntary patients had a significant impact, but a considerable amount of unexplained variance due to different practices within psychiatric hospitals remains.
| S-EPMC9086971 | biostudies-literature
Project description:Previous studies have identified hospitals with poor performance on cardiac process measures. How these hospitals fare in other domains, such as patient satisfaction, remains unknown.We used Hospital Compare data to identify hospitals reporting acute myocardial infarction (AMI) and heart failure (HF) process measures during 2006 to 2008, and calculated respective composite performance scores. Using these scores, we classified hospitals as low-performing (bottom decile for all 3 years), top-performing (top decile for all 3 years), and intermediate (all others). We used Hospital Consumer Assessment of Healthcare Providers and Systems 2008 data to compare overall satisfaction between low, intermediate, and top-performing hospitals. Low-performing hospitals had fewer beds, fewer nurses per patient, and were more likely rural, safety-net hospitals located in the South, compared with intermediate and top-performing hospitals (P<0.01 for all). After adjusting for hospital characteristics, patients were less likely to recommend low-performing hospitals to family or friends, relative to intermediate and top-performing hospitals (AMI: 58.8% versus 63.9% versus 68.8%, HF: 61.3% versus 64.0% versus 66.8%; P<0.001 for all), or provide an overall rating of ? 9 out of 10 (AMI: 56.7% versus 60.7% versus 64.9%, HF: 57.8% versus 61.1% versus 63.6%; P<0.01 for all). Despite the association between the hospital's performance on process measures and patient satisfaction, we noted discordance between these measures (kappa statistic <0.20).Hospitals with consistently poor performance on cardiac process measures also have lower patient satisfaction on average, suggesting that these hospitals have overall poor quality of care. However, there is discordance between the 2 measures in profiling hospital quality.
| S-EPMC3356685 | biostudies-literature
Project description:PURPOSE:Long lengths of stay (LoS) in psychiatric hospitals or repeated admission may affect the social integration of patients with psychiatric disorders. So far, however, studies have been inconclusive. This study aimed to analyse whether long LoS or repeated admissions in psychiatric wards were associated in different ways with changes in the social integration of patients. METHODS:Within a prospective cohort study, data were collected on 2181 patients with a main ICD-10 diagnosis of psychotic, affective, or anxiety disorder, hospitalised in the UK, Italy, Germany, Poland, and Belgium in 2015. Social integration was measured at baseline and 1 year after admission using the SIX index, which includes four dimensions: employment, housing, family situation, and friendship. Regression models were performed to test the association between LoS, the number of admissions, and the change in social integration over the study period, controlling for patients' characteristics (trial registration ISRCTN40256812). RESULTS:A longer LoS was significantly associated with a decrease in social integration (β = - 0.23, 95%CI - 0.32 to - 0.14, p = 0.03), particularly regarding employment (OR = 2.21, 95%CI 1.18-3.24, p = 0.02), housing (OR = 3.45, 95%CI 1.74-5.16, p < 0.001), and family situation (OR = 1.94, 95%CI 1.10-2.78, p = 0.04). In contrast, repeated admissions were only associated with a decrease in friendship contacts (OR = 1.15, 95CI% 1.08-1.22, p = 0.03). CONCLUSIONS:Results suggest that a longer hospital LoS is more strongly associated with a decrease in patients' social integration than repeated admissions. Special attention should be paid to helping patients to find and retain housing and employment while hospitalised for long periods.
| S-EPMC7578147 | biostudies-literature
Project description:To examine the influence of nursing-specifically nurse staffing and the nurse work environment-on quality of care and patient satisfaction in hospitals with varying concentrations of Black patients.Cross-sectional secondary analysis of 2006-2007 nurse survey data collected across four states (Florida, Pennsylvania, New Jersey, and California), the Hospital Consumer Assessment of Healthcare Providers and Systems survey, and administrative data. Global analysis of variance and linear regression models were used to examine the association between the concentration of Black patients on quality measures (readiness for discharge, patient or family complaints, health care-associated infections) and patient satisfaction, before and after accounting for nursing and hospital characteristics.Nurses working in hospitals with higher concentrations of Blacks reported poorer confidence in patients' readiness for discharge and more frequent complaints and infections. Patients treated in hospitals with higher concentrations of Blacks were less satisfied with their care. In the fully adjusted regression models for quality and patient satisfaction outcomes, the effects associated with the concentration of Blacks were explained in part by nursing and structural hospital characteristics.This study demonstrates a relationship between nursing, structural hospital characteristics, quality of care, and patient satisfaction in hospitals with high concentrations of Black patients.Consideration of nursing factors, in addition to other important hospital characteristics, is critical to understanding and improving quality of care and patient satisfaction in minority-serving hospitals.
| S-EPMC3217237 | biostudies-literature
Project description:AimTo determine the level of job satisfaction of nursing professionals in Slovenian hospitals and factors influencing job satisfaction in nursing.MethodsThe study included 4 hospitals selected from the hospital list comprising 26 hospitals in Slovenia. The employees of these hospitals represent 29.8% and 509 employees included in the study represent 6% of all employees in nursing in Slovenian hospitals. One structured survey questionnaire was administered to the leaders and the other to employees, both consisting 154 items evaluated on a 5 point Likert-type scale. We examined the correlation between independent variables (age, number of years of employment, behavior of leaders, personal characteristics of leaders, and managerial competencies of leaders) and the dependent variable (job satisfaction - satisfaction with the work, coworkers, management, pay, etc) by applying correlation analysis and multivariate regression analysis. In addition, factor analysis was used to establish characteristic components of the variables measured.ResultsWe found a medium level of job satisfaction in both leaders (3.49±0.5) and employees (3.19±0.6), however, there was a significant difference between their estimates (t=3.237; P=lt;0.001). Job satisfaction was explained by age (Plt;0.05; β=0.091), years of employment (Plt;0.05; β=0.193), personal characteristics of leaders (Plt;0.001; β=0.158), and managerial competencies of leaders (Plt;0.000; β=0.634) in 46% of cases. The factor analysis yielded four factors explaining 64% of the total job satisfaction variance.ConclusionSatisfied employees play a crucial role in an organization's success, so health care organizations must be aware of the importance of employees' job satisfaction. It is recommended to monitor employees' job satisfaction levels on an annual basis.
| S-EPMC3368291 | biostudies-literature
Project description:Quality in health care is commonly measured by patient satisfaction. This study assessed asthmatic patients' satisfaction with the pharmaceutical care services rendered in 2 Nigerian tertiary hospitals. This 3-arm intervention study was single-blinded, prospective, and randomized. The 3 arms were Usual Care, Individual Intervention, and Caregiver-assisted Intervention. Intervention arms received education for 6 months, whereas the Usual Care arm received no education. The Patient Satisfaction with Pharmaceutical Services questionnaire was utilized. Data were analyzed using the IBM SPSS Version 25.0 with statistical significance set as P < .05. Seventy-eight asthma patients participated in the 3-arm study. The majority of the patients (82.1%) were happy with the services provided by the pharmacists. More of the patients who received Individualized Intervention were highly satisfied, compared to those in the Caregiver-assisted Intervention arm and Usual Care arm (52.6% vs 44.7% vs 2.6%, χ2 = 32.124, P < .001). The Individualized Intervention satisfied patients better than the Caregiver-assisted Intervention. Pharmacists should strive to have direct communication with their patients despite the involvement of caregivers.
| S-EPMC8361507 | biostudies-literature