Artifact in client satisfaction assessment: experience in community mental health settings

Artifact in client satisfaction assessment is discussed and the results of a study of three factors thought to mediate client satisfaction ratings; (a) general life satisfaction, (b) mode of administration, and (c) psychological symptomatology, are reported. A standard client satisfaction questionnaire (CSQ) was modified to yield parallel forms and was administered orally and in writing to 92 clients in two mental health day treatment programs. Satisfaction ratings obtained from these clients were quite similar to out-patient ratings obtained in previous studies conducted in this setting and using the same measures. Oral administration of the CSQ produced 10% higher satisfaction ratings than written administration (p less than .05) and less missing data (p less than .01). Satisfaction ratings were also obtained using a simple graphic instrument. Graphic ratings were comparable to CSQ ratings. Satisfaction with life in general and level of psychiatric symptoms together accounted for 25% of CSQ variance. The implication of these findings for future client satisfaction research is discussed.     

Some factors related to contraceptive behavior among Wind River Shoshone and Arapahoe females

During the summer of 1972 in-depth interviews were conducted with 96 Shoshone and Arapahoe Indian women living on the Wind River Reservation in Central Wyoming. All were aged 15-49 and were users of the reservation health service. It was found the women fell into 4 groups: current contraceptive users, 42.7%; pregnant or seeking to become pregnant, 10.4%; infertile due to menopause or sterilization, 18.8%; and fertile never-users, 28.1%. The contraceptive users tended to be older, married, and have as many children as they want. The fertile never-users tended to be in their teens and generally unmarried. When asked why they did not use contraception their answer was 'because I am not married.' It is suggested that general education on contraception be provided the younger women so that when they achieve desired family size they will be informed as to family planning methods. It was found that religious belief against contraception was important to the young never-users, but not to the women who had completed their families. In fact, 73% of the users said their religion, which most identified as Roman Catholicism, had no influence on their contraceptive use while 27% said they were aware of church disapproval but used contraception anyway.     

International and internal migration decision making: a value-expectancy based analytical framework of intentions to move from a rural Philippine province

"The study compares determinants of internal and international migration intentions, drawing upon interview data from a sample of adults in Ilocos Norte, a largely rural province in the Philippines. A regression model is applied to test the relative determinants of intentions to migrate to Manila and to Hawaii. The study is based on a value-expectancy model of migration decision making. The results document the importance of subjective expectations related to the attainment of different values and goals in Manila and Hawaii."     

The use of traditional and modern methods of fertility control in Kinshasa, Zaire

Abstract The practice of post-partum abstinence has been a long-standing tradition in many societies of tropical Africa, yet recent research suggests an erosion of the taboo on post-partum sexual relations as a means of fertility control. The current study among women in the lower income groups in Kinshasa, Zaire, provides evidence of this. There is strong motivation toward child-spacing, as shown by 80 per cent of the women who reported to be currently practising some means of fertility control: 73 per cent with traditional methods, only 7 per cent with modern contraceptives. There appears to be some carry-over of traditional practice, in that abstinence is related to the age and nursing status of the last born child. However, the most widely practised method is withdrawal. This suggests a desire on the part of this population for alternatives to abstinence, an issue with important implications for future family planning programs in Zaire.     

The role of client satisfaction in evaluating university counseling services

Though ubiquitously used for evaluating university counseling services, client satisfaction assessment has been hampered by inadequate instrumentation. Systematic use of a short form of the Client Satisfaction Questionnaire (CSQ) in one such center over the past 5 years is described, together with strategies to ensure maximal accuracy and utilization of results. Several method factors were investigated. Optional respondent identification was not found to reduce response rate or increase reported satisfaction compared to anonymity, while a substudy obtaining very high response suggested bias from nonresponse to the routine survey (response rate = 40%) was not great. The CSQ was found to have excellent psychometric properties and many advantages for use in student service settings. Relationships between satisfaction and a number of other variables such as demographics, precounseling expectancies, problem type and severity, counselor differences, and duration of counseling are reported. Ways such findings were incorporated in service planning are briefly discussed.     

Assessment of patient satisfaction: development and refinement of a service evaluation questionnaire

A series of seven studies was conducted by the authors and their colleagues to produce an efficient measure of service satisfaction that can easily be related to symptom level, demographic characteristics, and type and extent of service utilization. The resulting measure, the Service Evaluation Questionnaire (SEQ) is a brief, global index that has excellent internal consistency and solid psychometric properties. Data from an extensive SEQ field study can be used as a comparison base for future applications of the two SEQ component scales, the CSQ-8 and the SCL-10. A new hypothesis has emerged from this series of studies that will guide future research: Service recipients may find if difficult to formally express dissatisfaction in the face of significant caring--however ineffectual--when the technical capacity to offer definitive treatment is not yet fully developed and when criteria for evaluating the efficacy of treatment are not yet crystal clear.     

Patient satisfaction with mental health services: a meta-analysis to establish norms

Patients typically express high rates of satisfaction with their mental health care. This finding and the lack of well controlled studies on patient satisfaction in the literature underscore the need for meaningful guidelines for clinicians and program evaluators in interpreting patient satisfaction data. To address this problem a meta-analysis was undertaken to establish norms on patient satisfaction for various types of mental health programs. Programs were categorized according to three dimensions: inpatient vs. outpatient vs. residential care; chronic vs. non-chronic; and conventional vs. innovative. Meta-analysis procedures were modified to accommodate the single-group study designs that dominate the literature. The analysis revealed that chronic patients express less satisfaction with their treatment compared to non-chronic patients. Innovative programs are viewed more positively than conventional ones. No differences were found in rates of patient satisfaction between inpatient and outpatient programs. Acceptably reliable norms and confidence intervals of patient satisfaction were established for conventional inpatient programs serving either chronic or non-chronic patients; conventional outpatient programs for non-chronic patients; and for all programs combined according to chronic vs. non-chronic, inpatient vs. outpatient, and conventional vs. innovative. However, data were insufficient to compute norms for other program types. The norms thus established can be used for comparative purposes by program evaluators. A cumulative, national data base on patient satisfaction is recommended to further refine these norms.     

Deterrence in the workplace: perceived certainty, perceived severity, and employee theft

The phenomenon of employee theft is examined empirically, utilizing a deterrence paradigm. Employees selected randomly from three different industry sectors and metropolitan areas were asked to self-report their involvement in a number of property theft activities within the employment setting. Using a weighted least-squares logit regression analysis, the study found that the perception of both the certainty and severity of organizational sanctions were related to employee theft. Males reported more theft than did females, but contrary to previous research, no gender/certainty or gender/severity interactions were observed. The best-fit model did, however, contain two significant first-order interactions: age/certainty and age/severity. These interactions strongly suggest that younger employees are not as deterrable as their older peers, especially under conditions of both high certainty and high severity of punishment. While a number of possible explanations might account for differential deterrability according to age, a commitment to or stakes in conformity explanation is proposed.     

Analysis of social pathologies in a policy context: A paradigm for action

Prevention continues to gain importance among the strategies open for governmental development of social policy. This paper offers two exploratory conceptual discussions related to prevention in social policy. The first is a representation of the policy making environment with special reference to the informational requirements for the development of policy. The second is a discussion of social pathologies, broadly defined as patterns of behavior with important negative repercussions on individuals whom we refer to as victims, and of possible strategies toward the development of (at least partial) preventive measures. The two discussions are interrelated as the shape of the second is dictated by the desiderata outlined in the first. The paper is divided into five parts:

1. Introduction: the conundrum of prevention.
2. The Development of a paradigm of the policy context.
3. Dependent variables: social pathologies.
4. Independent variables: a focus on structural determinants.
5. Conclusion: information requirements for preventive action.