Academic journal article Indian Journal of Psychiatry

A Study on Patient Satisfaction with Psychiatric Services

Academic journal article Indian Journal of Psychiatry

A Study on Patient Satisfaction with Psychiatric Services

Article excerpt

Byline: Prabhakar. Holikatti, Nilamadhab. Kar, Ajaya. Mishra, Rajnikant. Shukla, Sarada. Swain, Samrat. Kar

Context: Patient satisfaction with psychiatric services is an important construct, which influences multiple areas including treatment adherance and outcome. There is paucity of studies from India in this area. Aims: To measure satisfaction of psychiatric outpatients of Mental Health Institute, Cuttack, and to assess the relationship between demographic and clinical variables with different domains of patient satisfaction. Settings and Design: In a cross-sectional study, patients of age 18-60 years receiving treatment for at least six months from outpatient department of Mental Health Institute, SCB Medical College, Cuttack, were assessed. Materials and Methods: Participants (n=60) were selected randomly. Satisfaction was assessed by Patient Satisfaction Questionnaire-18 (PSQ-18) and the diagnoses were based on the Diagnostic and Statistical Manual-IV-TR. Severity of psychiatric disorder was measured using Clinical Global Impression-severity scale. The functioning level was assessed by Global Assessment of Functioning. Statistical Analysis: Continuous variables compared using independent t-test or analysis of variance. Results: Diagnostic break-up of the patients included anxiety disorder (36.6%), major depressive disorder (30.0%), bipolar disorder (16.6%), and schizophrenia (16.6%). Greatest level of satisfaction was noted in interpersonal aspects (71.4%) and time spent with doctors (62.4%). General satisfaction level was a little over 50% (57%). Differences between composite scores of PSQ-18 in the diagnostic categories were statistically significant; patients with depression had the highest score followed by those with anxiety disorder, bipolar, and the least was with schizophrenia patients. There was variability among the demographic and clinical groups regarding the various subscale score of PSQ-18. Conclusions: Satisfaction of psychiatric outpatients was observed to be different in various clinical and demographic groups and across many domains of satisfaction.

Introduction

Patient satisfaction is an evaluation of quality of care, an outcome variable in its own right, and is an indicator of weaknesses in the service. [sup][1] Studies indicate that global satisfaction is affected by many factors other than the quality of service delivery; it may include factors such as patients' demographics, [sup][2],[3] diagnosis, [sup][4],[5] treatment programme, [sup][6] and chronicity of disease. Among demographic characteristics, age, health status, and race had a consistent, statistically significant effect on satisfaction scores and among the institutional characteristics, hospital size had a consistent and significant effect on patient satisfaction scores. [sup][7]

Factors for high satisfaction

In a meta-analysis, greater patient satisfaction was found to be significantly associated with greater age, less education, being married, and having higher social status. [sup][8] A study on patient satisfaction with outpatient psychiatric care showed a high general satisfaction with treatment. [sup][9] Satisfaction was highest in areas of treatment planning/treatment design, treatment accomplishment, and relationship to staff. A somewhat lower level of satisfaction was noted concerning information and co-influence of the patient. [sup][9] Level of satisfaction was not related to social and psychiatric background characteristics. Patients with longer time in therapy showed a higher level of satisfaction. [sup][10]

Holcomb et al. found that severely ill inpatients who reported fewer symptoms, higher quality of life, and a higher level of functioning at admission tended to be more satisfied with their services. In addition, patients who were employed at admission, and therefore most likely functioning at a higher level in the community, rated their treatment more positively. …

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