FACTORS ASSOCIATED WITH PERCEIVED SATISFACTION IN HEMODYALISIS PATIENTS

Author(s)

Covadonga Valdes, MsC, Researcher1, Mercedes Miguel, Msc, Nurse1, Yolanda Artos, Msc, Nurse1, Marta Alvarez, Msc, Nurse2, Elsa Portero, Msc, Nurse2, Teresa Ortega, PhD, Researcher Coordinator1, Francisco Ortega, MD, PhD, Nephrologist, medical staff11Hospital Universitario Central de Asturias, Oviedo, Spain; 2 Cruz Roja de Oviedo, Oviedo, Spain

OBJECTIVES: To develop brief patient evaluation or satisfaction surveys, knowing patients' priorities can be helpful in deciding which aspects of care should be tracked and to improve the quality of the cares. On the other hand it is necessary to identify the characteristics of the patients and the own medical services that are influencing the patient satisfaction. The aims of the study were to assess the patient’s satisfaction in two haemodialysis units, one public, the Hospital Universitario Central de Asturias Unit, and the arranged health centre Cruz Roja Unit, and to analyze which variables  were associated to it. METHODS: All patients (N=140) were interviewed by a psychologist that belongs to Nephrology Unit with SERVQHOS survey, previously used in our country and that measures the satisfaction with twenty aspects of the Unit. Patient's HRQOL was evaluated, using both components of the EQ-5D: the five dimensions, Mobility, Self-Care, Usual Activities, Pain, Anxiety/Depression and their Tariff, and the Visual Analogue Scale. Also were collected the answers to questions that previous studies found that could be conditioning the satisfaction, sociodemographic, pharmacological and clinical data. Nurses scored the functional impairment of patients with the Karnofsky Performance Scale and the Barthel Scale. RESULTS: Finally 128 patients, 65.6% men, completed the interview. Mean age was 65.67 ± 16.54 and mean of months on dialysis was 28.47±44.50. SERVQHOS Alfa's reliability  was 0.96.The satisfaction levels were similar to those found in other haemodialysis units in Spain and higher in the arranged health centre in 6 aspects (p<0.05). Patients were more satisfied with those aspects related with the kindness and the disposal of the unit staff, and less satisfied with those related with the facility to go to the unit and the punctuality of the sessions. Lower satisfaction levels were related with worse self-score of the health the day of the interview that the rest of the year, time since starting dialysis, longer sessions, no dose of iron, female gender, to have been transplanted previously, higher haemoglobin and haematocrit levels and lower age (p<0.05). Otherwise, lower educational levels, less qualified jobs, a good valuation of the ambulance to go to the unit, to think that the renal illness and the dialysis is well explained, and mainly that patient opinion is considered to treat the renal disease, increased the satisfaction with the measured aspects (p<0.05). CONCLUSIONS: To identify those factors that are modulating the satisfaction is as important as to measure it, since they indicate what issues need to be enhanced in order to increase the perception of the quality of the service. Also it must be considered that exist factors attached to patients, as socioeconomic level, physical and mental status, and the own experience with the illness that are influencing the perceived satisfaction. These findings indicate that it seems necessary as well to leave the paternalistic model and that clinicians should give patients more information and autonomy in order to make decisions about the illness, since the perception of the autonomy is associated with patient satisfaction

Conference/Value in Health Info

2008-11, ISPOR Europe 2008, Athens, Greece

Value in Health, Vol. 11, No. 6 (November 2008)

Code

PUK22

Topic

Patient-Centered Research

Topic Subcategory

Patient-reported Outcomes & Quality of Life Outcomes, Stated Preference & Patient Satisfaction

Disease

Urinary/Kidney Disorders

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