Patients' requests and satisfaction services in an outpatient psychiatric setting

Community Psychiatric Centre, Douglas Hospital, Verdun, Quebec, Canada.
Psychiatric Services (Impact Factor: 2.41). 04/1996; 47(3):287-92.
Source: PubMed


Patients in four major diagnostic categories were compared to determine if their satisfaction with outpatient services varied. Both overall satisfaction and the degree to which clients and therapists agreed on the importance of 16 aspects of treatment were examined.
The Patient Request Form (PRF) and the Client Satisfaction Questionnaire were used to interview 464 outpatients. The professional who was the primary contact for each patient filled out a therapist version of the PRF. Diagnoses were grouped into four major categories: anxiety disorders, affective disorders, schizophrenia, and other psychotic disorders.
The diagnostic groups differed in overall satisfaction with treatment, treatment characteristics, patients' reasons for coming to the clinic, therapists' descriptions of treatment, and patient-therapist agreement on the importance of different aspects of treatment. Agreement between patients and providers was associated with higher levels of patients' satisfaction. Patients with schizophrenia or with other psychotic disorders had the lowest level of agreement with their therapists and also were the least satisfied. In all patient categories, therapists underestimated the importance to patients of having a reliable source of help.
The greater dissatisfaction expressed by patients with schizophrenia and other psychotic disorders may be related to their therapists' undervaluing the nonbiological aspects of treatment such as social support. Combining medication with psychosocial approaches that have been adapted for patients with psychotic disorders is likely to improve the patients' satisfaction and compliance and increase the overall effectiveness of treatment.

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    • "In order to capture references from the broad medical field, where extensive research had occurred, we searched for articles on ''general satisfaction'' [13], ''treatment satisfaction'' [3] [9] [10] [51], ''satisfaction with care'' [12] [27] and ''patients expectations'' [34]. In order to capture relevant references from the psychiatry field, we searched for articles on ''satisfaction with services'' [24] [40] [44], ''compliance'' [4] [26], ''subjective experience'' [5] [16], ''subjective well-being'' [17] [39], ''subjective effects'' [37] or ''attitudes towards'' medication [28] and ''subjective tolerability'' [50]. In parallel to this search, we used the results of a previous study where a structural equation model of patients' satisfaction [20] suggested the existence of nine relevant dimensions: ''subjective perception of: effectiveness on symptoms and; global functioning'' (i.e., non-clinical aspects); subjective perception of ''side effects''; attitude towards side effects; ''attitude toward the actual idea of treatment''; global impression on the medication and lastly, three items regarding satisfaction with the physician: ''relationship with the physician, information given on the treatment, and confidence in the prescriber''. "
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    ABSTRACT: Purpose: The PAtient SAtisfaction with Psychotropic (PASAP) scale is a self-completed questionnaire measuring satisfaction with psychotropic medication. The aim of the study was to describe its development in French and its psychometric properties. Materials and methods: Scale construction was based on an extensive search of the literature. The item reduction process required semi-structured interviews of psychiatric outpatients (n=30). The final version of the PASAP is a 9-item, 5-point Likert-type scale, covering the scope of effectiveness and adherence. To assess the psychometric properties of the scale, French patients with an acute manic episode (n=314) from a large European observational cohort completed the PASAP scale 3 months after psychotropic treatment initiation/change. Internal validity and reliability were assessed using principal component analysis (PCA). Concurrent validity was assessed using comparisons to physician-rated satisfaction with life, illness severity, mood relapse, compliance and side effects. Results: Participation rate was 68.4%. PCA was in favour of uni-dimensionality. Cronbach's α coefficient was 0.85 (95%CI 0.83-0.88). All five concurrent measures were significantly associated with the PASAP score. Conclusion: The PASAP scale showed good psychometric properties in a large bipolar population and thus seems adequate for evaluating treatment satisfaction. Its short length and good acceptability makes it suitable for clinical research.
    Full-text · Article · Jun 2013 · European Psychiatry
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    • "Adolescents' diagnostic presentation is an important variable that can potentially influence satisfaction with services. A few studies that have examined the effects of diagnosis on satisfaction with mental health services in adults found that clients diagnosed with more severe and chronic mental illness (e.g., schizophrenia, bipolar disorder , personality disorders) are less satisfied with treatment than clients with less severe diagnoses (e.g., affective, anxiety, and adjustment disorders; Hasler et al. 2004; Kelstrup et al. 1993; Perreault et al. 1996). However, only one study has examined the nature of this relationship in adolescents. "
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    ABSTRACT: Consumer satisfaction with treatment is important information for providers of mental health services. The goal of the current study was to examine the relationship between youth and parent satisfaction ratings and the following youth variables: gender, age, primary diagnosis, and changes in functioning and symptomatology after 6 months of services. Results demonstrated that in a large sample of youth receiving community mental health services satisfaction with services differed as a function of the adolescents' clinician-derived primary diagnosis, age, and reported changes in symptoms and functioning. Although significant, these variables accounted for only a small portion of the variance in satisfaction. Additionally, the relationship between parent and youth ratings of satisfaction was low, but significant. The implications of these findings are discussed as well as future directions for clinicians and researchers.
    Full-text · Article · Feb 2010 · Community Mental Health Journal
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    • "Nevertheless, the published work on the predictors of service satisfaction is inconsistent and generally of poor scientific quality. Conflicting results have been obtained on the relationship between patients' satisfaction and their sociodemographic characteristics , type of diagnosis, and severity of illness (Larsen et al. 1979; Hansson 1989; Kelstrup et al. 1993; Perreault et al. 1996; Leavey et al. 1997; Greenwood et al. 1999). On balance, the results of previous studies show that users' characteristics have a weak to moderate association with service satisfaction. "
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    ABSTRACT: Patient satisfaction with services is an important outcome variable that is increasingly used in mental health service evaluation. This study includes 404 people with schizophrenia in five European sites and addresses five questions focused on site, service, and patient characteristics as variables that might explain service satisfaction, using the Verona Service Satisfaction Scale. Patient satisfaction differed significantly across sites (highest in Copenhagen, lowest in London). In all sites, patients were least satisfied with involvement of relatives in care and information about illness. A multiple regression model showed that lower levels of total service satisfaction were associated with living in London or Santander, being retired/unemployed, having more hospital admissions, having more severe psychopathology, having more unmet needs, or having lower satisfaction with life. This model explained 31 percent of variance in service satisfaction. Our data show that service satisfaction can be seen as a result of (1) the ability of the service to provide a standard of care above a certain quality thresh old, and (2) the perception of each patient that the care received has been tailored to the patient's own problems.
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