ARTICLE INFO

Article Type

Descriptive & Survey Study

Authors

Pirooz   F. (*)
Nuri   M. (1)
Goli   M. (2)






(*) “Aging Research Center”, “Aging Department, Social Science Faculty”, University of Social Welfare & Rehabilitation Sciences, Tehran, Iran
(1) Infectious Diseases Department, Medicine Faculty, Army Medical University, Tehran, Iran
(2) Anthropology ‎ Department, Medicine Faculty, Army University of Medical Sciences, Tehran, Iran

Correspondence

Address: Aging Department, Social Science Faculty, University of Social Welfare & Rehabilitation Sciences, ‎Koudakyar Street, Evin, Tehran, Iran. Postal Code: 1668619551
Phone: +98 (21) 22180004
Fax: +98 (21) 22542796
fereshtehpirooz@gmail.com

Article History

Received:  August  8, 2017
Accepted:  February 24, 2018
ePublished:  August 29, 2018

BRIEF TEXT


Patient satisfaction is a good measure for assessing the quality of health care provided by the staff. ... [1].

... [2-11]. Many studies on patient satisfaction measure high levels of satisfaction, while in practice often unfulfilled needs are observed [12]. On the other hand, studies have shown that the level of satisfaction among people from different social classes, age, gender, and cultural groups, as well as different services and types of care may vary [13]. In addition to increasing competition in the health market, these approaches have led to a significant increase in patient satisfaction in the last decade and a significant increase in the publication of articles in this regard [4, 7, 14]. ... [15-17].

The purpose of the present study was to assess the satisfaction of hospitalized patients in one of Tehran's hospitals (which holds about half of the clients in the armed forces booklet and has the honor to serve demented veterans and their families).

This study is a cross-sectional and descriptive-analytic study. Research society, place and time This study was conducted among patients admitted to all departments (non-emergency) of Golestan Hospital (Tehran) with a residence time of more than one day for one year from April 2016 to the end of March of the same year.



The samples were selected from the target population using convenience sampling method. Considering that the average admission rate of the patient admitted in each month was 767 and the total number of people who were admitted for more than 24 hours was estimated at 8,000, using the Cochran formula, and according to available data from 2014 and 2015 that it was estimated that about 65% of patients hospitalized in the hospital were in the project, the sample size needed for research was at least 357 people. Finally, 426 patients participated in the study and answered the questionnaire questions. The criteria for entering the study included at least 24 hours admission, full satisfaction for inclusion in the study, full cognitive-psychological health based on self-declaration and lack of alertness decrease (based on the recorded report in the initial assessment of the patient), no the need for an interpreter for interview and age higher than 12 years old. Patients who needed an interpreter, who had decrease of alertness, who were unaware of the time and place and did not want to participate in the survey, were excluded.

The questionnaires were provided to patients by a trained interviewer in the morning shift (with the same conditions). In most cases, one social worker (female) and, in the case of her absence, a psychologist (female), covered all days of the week throughout the year. The questionnaire was completed as a "face-to-face interview", and only 11.33% (47 cases) of the questionnaires were completed by the patient himself/herself or patient caregiver in the presence of the designer. All completed questionnaires were collected and the data were extracted from the questionnaires and recorded in the relevant electronic file. The questionnaire consisted of two parts: demographic and proprietary information. The standard checklist of patient satisfaction from the health system development plan developed by Guilan University of Medical Sciences was used [18] and after adding supplementary questions in other areas, the face validity of the questionnaire was confirmed by calculating the effects of the item, which was more than 1.5 for all questions. The questionnaire consisted of 42 closed questions, in addition to the patient's specifics, to assess the 8 areas (admission and waiting times, medical services, nursing services, hospital services, food status, hospitalized radiology services, hotel / grooming and amenities, clearance services And fund). The content validity of the questionnaire was confirmed based on content validity coefficient and after submission to the 10 experts of Army Medical Sciences University and necessary corrections were confirmed with Cronbach's alpha coefficient of 0.91 and its reliability was confirmed by test-retest method for 10 days for 15 patients which was evaluated 0.81. The degree of satisfaction of individuals using the Likert Five Likelihood Scale was evaluated for evaluating each service with "completely satisfied", "fairly satisfied", "relatively dissatisfied", "completely dissatisfied" and "no opinion" options (5 to 1, respectively). At the end of the interview, each patient was asked “if he wished to call him 5 days after the discharge for the expression of the ideas, suggestions and with the aim of pursuing”, so that, if the discretion is given, the comments submitted are authenticated, corrected and complete. Only 209 participants participated in the follow up project but did not change any of the comments expressed in the completed questionnaire during admission. To score points for each question, score between 1 and 1.80 (completely dissatisfied), between 1.81 and 2.60 (relatively dissatisfied), between 2.61 and 3.40 (no opinion), between 3.41 and 4.20 (fairly satisfied) and between 4.21 and 5 (fully satisfied) were considered. Given that the patient had the opportunity to give a positive / negative opinion, if the respondent choose "no opinion," adopting the approach of lacking significant satisfaction or dissatisfaction, the researcher did not consider such cases in calculating the total satisfaction. Data were analyzed by SPSS 16 software and descriptive statistical methods including frequency, percentage, mean and standard deviation for quantitative and absolute data and relative frequency for qualitative data and independent variance, chi-square and independent T tests.

Of the 426 hospitalized patients, 189 patients were male and 237 patients were female, with a mean age of 49.67 ± 38.41 years, ranging from 8 to 96 years (Table 1). Also, 23.47% of patients admitted to this center in 2016 were veterans and the families of veterans and martyrs (mostly from the family of armed forces and martyrs of service). These statistics were extracted based on the type of hospital records and discounts and income of the accounting unit, and this question was not included in the questionnaires from the beginning. On average, the most satisfaction of hospitalized patients was from the services provided by the physicians (with 91.37% of cases or 389 patients) and the lowest satisfaction was with the food status (quantity, quality, type of serving, serving time, selective menu appropriate to the diet, etc. with 60.55% of cases or 258 patients). In the year 2016, 75.89% of hospitalized patients (323 patients) were satisfied with the nursing team. 79.67% of hospitalized patients (339) was satisfied with hoteling. 73.73% of admitted patients (314 people) were satisfied with the hospital para clinic team (radiology and laboratory). 74.47% of the hospitalized patients (317 patients) were satisfied with received services provided by the admissions department and 62.59% of hospitalized patients (267 people) were satisfied with the services provided by the discharge department and the hospital fund (they had selected the satisfaction score between 3.41 to 5.). Only gender variable did not have any significant relationship with satisfaction component (p = 0.052), and three variables of marital status (p = 0.004), educational level (p <0.001) and age (p = 0.002) had a significant relationship with satisfaction (Table 2).

Based on the results, most of the patients admitted to Golestan Hospital were satisfied with the health services offered at the center, which was not consistent with the Khamis study at the Tanzanian Hospital, who stated that a high percentage of patients did not satsified with the quality of the services offered in the hospital. However, the study was consistent with the study of Goodarzian et al in Mazandaran Provincial Educational Hospitals that they reported the score of satisfaction of hospitalized patients as 18.73 ± 2.53% [20]. In this study, the highest satisfaction of patients was with the services provided by physicians and the lowest satisfaction was with food status that was found not to be consistent with Goodreadian et al. [20]. ... [21]. Khezri et al study showed that 1.1% of the patients had complete satisfactory with nursing services, 14.2% had moderate satisfaction and 84.4% were dissatisfied [15]. In a study conducted in Behshahr, only 3% of persons had complete satisfaction with the nursing staff, 20% had moderate satisfaction, and 77% of the hospitalized patients were dissatisfied with nursing service [22], both of which were not consistent with the findings of this study [23-25].

It is suggested that similar studies be carried out at other centers to enhance the quality and quantity of services provided by sharing the experiences of health centers.

In this study only patients who were admitted to the public sector and conscious patients who were admitted to special sectors who were willing to answer and complete the questionnaire were examined. On the other hand, lack of random sampling and individual and cultural differences of the subjects were also of the limitations of the project, which we tried to avoid their effects on the results of the work.

Marital status, educational level and age are related to the degree of satisfaction of hospitalized patients, but gender is not related to satisfaction.

All patients admitted to the hospital and their fellows, head nurses and staff of all hospital departments in Golestan Hospital, Mr. Hossein Sharifi (head of the Department of Law Services at the Hospital), Ladies Forough Sheikh, Sedigheh Memarian, Zohreh Sadat Nabavi and Fatemeh Arij, who were responsible for preparing and completing Questionnaires, extracting and recording information, are appreciated.

There are no conflicts of interest.

While complying with the requirements of the Ethics Committee, the confidentiality of all information obtained from participants in the research was guaranteed.

The costs of this research have been paid in person.

TABLES and CHARTS

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