Comparison of indirect and direct approaches to measuring patient satisfaction

One indirect (PSQ) and two direct (CSQ-18B and ERS) measures of patient satisfaction were compared across a series of psychometric, acceptability, and concurrent validity criteria. None of the three measures was significantly related to health status or demographic characteristics. Each measure performed as expected from prior research on their psychometric properties. The scales contrasted, however, in regard to acceptability, with the PSQ being much less acceptable to patients than the other two. The PSQ also produced more missing data. The results on the PSQ reflected patient inconsistency on cross-check items and patients tended to be uncertain in their responses to many items. In multivariate analyses the three measures were used as predictors of patient-rated indices of global service satisfaction. The CSQ-18B and the ERS were significant predictors of patient-rated indices of global service satisfaction, whereas the PSQ was unrelated to these indices. It was concluded that the direct and indirect approaches measure different satisfaction domains. The PSQ likely assesses more generalized attitudes about health services while the CSQ-18B and the ERS efficiently reflect opinions about the specific setting in which they are administered.     

Lone Parents and Civil Law: Their Experience of Problems and Their Advice-seeking Behaviour

The percentage of dependent children living in lone‐parent families has more than tripled in Britain over the last 30 years. Though there is much diversity within this lone‐parent population, there are common experiences and characteristics. Lone‐parent families tend to be headed by women, to be poor, on benefits and experience problems with ill health and disability. This paper examines lone parenthood in the context of the experience of justiciable problems (problems for which there is a potential legal remedy), drawing upon a large‐scale survey of 5,611 people representative of the population of England and Wales. The survey included 223 lone parents, who were likely to be female, to be living in rented accommodation, to be on a low income, to be economically inactive and to be in receipt of benefits. Lone parents were significantly more likely than others to have experienced a justiciable problem. Lone parents sought advice for their problems more often than others, particularly from solicitors, even after controlling for problems experienced. Lone parents were more likely than others to receive legal‐aid funding. Lastly, lone parents found trying to resolve problems particularly stressful, though they tended to believe that their life had improved as a consequence of doing so.     

Patient satisfaction in primary health care: a literature review and analysis.

This paper reviews the literature on patient satisfaction in primary health care settings. Definitions and models of satisfaction are considered first. Attention is given to the conceptualization of satisfaction by investigators concerned about consumers in general as well as by researchers focusing on consumers of medical services. Research findings are discussed and used to develop a model of patient satisfaction. The measurement of patient satisfaction and the findings of empirical studies are then reviewed, including summaries of effect sizes. It is concluded that patient satisfaction information can provide a dependent measure of service quality and serves as a predictor of health-related behavior. Issues deserving further investigation and recommendations regarding research strategies are presented.     

Understanding parental leave experiences: connecting the dots with a multiple-methods approach

ABSTRACT

This research note draws selected findings from a multiple-methods study conducted in partnership with a large public-sector employer in Portland, OR to describe the added value of this approach for research translation. We focus on how our study of a newly implemented paid parental leave policy can translate to actionable steps for two important end-users: employers and policymakers. Using administrative records (N?=?579), a countywide employee survey (N?=?137 leave-takers) and focus groups (N?=?35), we describe how each data source contributes important and unique information about how the policy’s implementation affected diverse employees. We find gender differences in how employees changed leave-taking in response to the policy, and describe the critical but nuanced role that supervisors play. Working with employers and policymakers to develop and implement thoughtful policies will help to ensure equitable distribution of the benefits of paid leave policies.     

A sociology of bullying: Placing youth aggression in social context

In this paper we review the sociological literature on peer aggression among adolescents and demonstrate how it can form the basis of a new subfield in sociology on the subject of bullying. Although sociologists have mostly avoided the term bullying in classic works on adolescent aggression, these studies suggest that institutional social control, status hierarchies and social inequalities provide important social context for youth aggression. While historically they have not been in dialog with each other, when taken together sociological research on youth status relations and social networks, systemic bias, school culture and social ecology can lay the foundation of a sociology of bullying. We suggest that if sociologists see this work as shedding light on issues of bullying, they can begin to play a larger role in the shaping of the national conversation on bullying and influence anti-bullying programs in schools to take better account of the social dimensions of bullying.     

Measuring Self-Appraised Changes following Participation in an Intervention for Caregivers of Individuals with Dementia

This study examined the psychometric properties of the Self-Appraisal of Change Scale, a measure designed to capture domains that are subjectively relevant to caregivers, associated with overall well-being, and amenable to change upon engaging in an intervention. Data from 107 caregivers of veterans with dementia enrolled in a randomized controlled trial of a telephone-delivered caregiver psychoeducation and support group program (the Telehealth Education Program (TEP)) were analyzed. The TEP, which was delivered by master’s prepared social workers and a nurse dementia care manager, targeted caregivers’ dementia-related knowledge, attitudes, and self-management skills. Analyses were conducted to determine the factor structure, reliability, validity, and measurement invariance of the scale. Factor analyses yielded a single-factor solution for the scale’s nine items. The reliability and construct validity of the scale were also supported by the analyses. Multi-group analyses suggested that meaningful comparisons of scale items and total raw scores can be made across usual care (UC) and intervention groups. The findings offer preliminary support that the scale may represent a valid and reliable instrument that captures perceived changes in key domains (e.g. caregiving knowledge, attitudes, and skill) following participation in a psychoeducational and support intervention trial.     

The evaluation ranking scale: clarification of methodological and procedural issues

Compared with CSQ-8, a typical questionnaire approach to assessing global patient satisfaction, the Evaluation Ranking Scale (ERS) had equally good patient acceptability, yielded more normally distributed satisfaction scores, and results allowed comparative information about patients' evaluation of specific service dimensions. The study also addressed key questions that have emerged about the ERS procedure. Patients apparently do not distinguish conceptually between "importance" of dimensions and "satisfaction" with dimensions in the first phase (ranking) of the ERS. Results did confirm that the ERS sequence of ranking and then rating the dimensions is essential to achieving optimal utility of results. The ranking task seems to have an organizing effect on patients' approach to the rating task. This effect does not work to dictate results in the rating phase but rather seems to familiarize patients with the dimensions to be rated thereby yielding greater potential discriminative capacity for the ERS. Finally, results indicate that the ERS can be administered in a flexible fashion that yields additional information about the absolute importance of the six dimensions without loss of desired operating characteristics for the measure.     

The evaluation ranking scale: a new methodology for assessing satisfaction

Most patient satisfaction scales produce high, undifferentiated levels of reported satisfaction that fail to detect program areas that consumers do not like. Methodological problems apparently contribute to these results. An alternative procedure, the Evaluation Ranking Scale (ERS), was formulated and tested. A 2 X 3 design was employed with 246 public health center patients randomly assigned to one of two measurement techniques (ERS vs. a global measure) and one of three informational sets. A secondary group of subjects was a convenience sample of 26 staff members, which allowed comparisons of staff evaluations of the health center to patients' evaluations of the health center. Compared to the global measure, the ERS provided more specific information about particular program components, was more discriminating, and resulted in mean satisfaction scores that were significantly lower. This new approach may be a more effective technique for assessing the psychosocial effectiveness of human service programs.