Skip to main content
SpringerLink
Log in

A Multivariate Model of Patients' Satisfaction with Treatment for Posttraumatic Stress Disorder

  • Published:
Journal of Traumatic Stress

Abstract

Prior studies have concluded that patients' pretreatment characteristics contribute more to their satisfaction with mental health treatment than any other domain. We expand the representation of treatment characteristics in an examination of satisfaction across both inpatient and outpatient settings. Data were drawn from an inpatient (n = 831) and an outpatient (n = 554) study of the treatment of PTSD. We used structural equation modeling to specify and evaluate a model of satisfaction with comparable elements for inpatient and both short and long-term outpatient treatment. Results indicate that the quality and quantity of patients' participation in treatment were more important to the development of their satisfaction with treatment than their pretreatment characteristics. Among treatment characteristics, the social climate of the inpatient milieu and the focus on war traumas in outpatient therapy had major effects on the quality and quantity of patients' participation and their satisfaction.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Abramowitz, S., Cote, A. A., & Berry, E. (1987). Analyzing patient satisfaction: A multianalytic approach. Quality Review Bulletin, 13, 122–130.

    Google Scholar 

  • Anderson, L. A., & Zimmerman, M. A. (1993). Patient and physician perceptions of their relationship and patient satisfaction: A study of chronic disease management. Patient Education and Counseling, 20, 27–36.

    Google Scholar 

  • Arnold, A. L. (1985). Inpatient treatment of Viet Nam veterans with post-traumatic stress disorder. In S. M. Sonnenberg, A. S. Blank, & J. A. Talbott (Eds.), The trauma of war: Stress and recovery in Viet Nam veterans (pp. 241–261). Washington, DC: American Psychiatric Press.

    Google Scholar 

  • Attkisson, C. C., & Zwick, R. (1982). The Client Satisfaction Questionnaire: Psychometric properties and correlation with service utilization and psychotherapy outcome. Evaluation and Program Planning, 5, 233–237.

    Google Scholar 

  • Baker, R. (1996). Characteristics of practices, general practitioners and patients related to levels of patients' satisfaction with consultations. British Journal of General Practice, 46, 601–605.

    Google Scholar 

  • Bollen, K. A. (1989). Structural equations with latent variables. New York: Wiley.

    Google Scholar 

  • Covinsky, K. E., Rosenthal, G. E., Chren, M. M., Justice, A. C., Fortinsky, R. H., Palmer, R. M., et al. (1998). The relation between health status changes and patient satisfaction in older hospitalized medical patients. Journal of General Internal Medicine, 13, 223–229.

    Google Scholar 

  • Deane, F. P. (1993). Client satisfaction with psychotherapy in two outpatient clinics in New Zealand. Evaluation and Program Planning, 16, 87–94.

    Google Scholar 

  • Edwards, D. W., Yarvis, R. M., Mueller, D. P., & Langsley, D. G. (1978). Does patient satisfaction correlate with success? Hospital and Community Psychiatry, 29, 188–190.

    Google Scholar 

  • Fontana, A., & Rosenheck, R. (1994). A short form of the Mississippi Scale for measuring change in combat-related PTSD. Journal of Traumatic Stress, 7, 407–414.

    Google Scholar 

  • Fontana, A., & Rosenheck, R. (1997a). Effectiveness and cost of inpatient treatment of posttraumatic stress disorder. American Journal of Psychiatry, 154, 758–765.

    Google Scholar 

  • Fontana, A., & Rosenheck, R. (1997b). Outcome monitoring of Specialized Intensive PTSD Programs: Fiscal year 1996 report. West Haven, CT: Northeast Program Evaluation Center.

    Google Scholar 

  • Fontana, A., & Rosenheck, R. (1999). A model of war zone stressors and posttraumatic stress disorder. Journal of Traumatic Stress, 12, 111–126.

    Google Scholar 

  • Fontana, A., & Rosenheck, R. (2001). A model of patients' satisfaction with treatment for posttraumatic stress disorder. Administration and Policy in Mental Health, 28, 475–489.

    Google Scholar 

  • Ford, J. D. (1999). PTSD and disorders of extreme stress following warzone military trauma: Comorbid but distinct syndromes? Journal of Consulting and Clinical Psychology, 67, 3–12.

    Google Scholar 

  • Ford, J. D., Fisher, P., & Larson, L. (1997). Object relations as a predictor of treatment outcome with chronic PTSD. Journal of Consulting and Clinical Psychology, 65, 547–559.

    Google Scholar 

  • Ford, J. D., & Kidd, P. (1998). Early childhood trauma and disorders of extreme stress as predictors of outcome for chronic posttraumatic stress disorder. Journal of Traumatic Stress, 11, 553–571.

    Google Scholar 

  • Friedman, M. J. (1997). Drug treatment for PTSD: Answers and questions. Annals of the New York Academy of Sciences, 821, 359–371.

    Google Scholar 

  • Greenwood, N., Key, A., Burns, T., Bristow, M., & Sedgwick, P. (1999). Satisfaction with in-patient services: Relationship to patient and treatment factors. British Journal of Psychiatry, 174, 159–163.

    Google Scholar 

  • Hall, J. A., Irish, J. T., Roter, D. L., Ehrlich, C. M., & Miller, L. H. (1994). Satisfaction, gender, and communication in medical visits. Medical Care, 32, 1216–1231.

    Google Scholar 

  • Hansson, L., & Berglund, M. (1987). Factors influencing treatment outcome and patient satisfaction in a short-term psychiatric ward. European Archives of Psychiatry and Neurological Sciences, 236, 269–275.

    Google Scholar 

  • Hayduk, L. A. (1987). Structural equation modeling with LISREL. Baltimore: Johns Hopkins University Press.

    Google Scholar 

  • Holcomb, W. R., Parker, J. C., Leong, G. B., Thiele, J., & Higdon, J. (1998). Customer satisfaction and self-reported treatment outcomes among psychiatric inpatients. Psychiatric Services, 49, 929–934.

    Google Scholar 

  • Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1–55.

    Google Scholar 

  • James, L. R., Mulaik, S. A., & Brett, J. (1982). Causal analysis: Models, assumptions, and data. Beverly Hills, CA: Sage.

    Google Scholar 

  • Johnson, D. R., Lubin, H., Rosenheck, R., Fontana, A., Charney, D., & Southwick, S. (1999). Comparison of outcome between homogeneous and heterogeneous treatment environments in combat-related posttraumatic stress disorder. Journal of Nervous and Mental Disease, 187, 88–95.

    Google Scholar 

  • Johnson, D. R., Rosenheck, R. A., Fontana, A., Lubin, H., Charney, D. S., & Southwick, S. M. (1996). Outcome of intensive inpatient treatment for combat-related posttraumatic stress disorder. American Journal of Psychiatry, 153, 771–777.

    Google Scholar 

  • Kane, R. L., Maciejewski, M., & Finch, M. (1997). The relationship of patient satisfaction with care and clinical outcomes. Medical Care, 35, 714–730.

    Google Scholar 

  • Kasprow, W. J., Frisman, L., & Rosenheck, R. A. (1999). Homeless veterans' satisfaction with residential treatment. Psychiatric Services, 50, 540–545.

    Google Scholar 

  • Katz, J. N., Lipson, S. J., Brick, G. W., Grobler, L. J., Weinstein, J. N., Fossel, A. H., et al. (1995). Clinical correlates of patient satisfaction after laminectomy for degenerative lumbar spinal stenosis. Spine, 20, 1155–1160.

    Google Scholar 

  • Lambert, W., Salzer, M. S., & Bickman, L. (1998). Clinical outcome, consumer satisfaction, and ad hoc ratings of improvement in children's mental health. Journal of Consulting and Clinical Psychology, 66, 270–279.

    Google Scholar 

  • Lebow, J. L. (1983). Research assessing consumer satisfaction with mental health treatment: A review of findings. Evaluation and Program Planning, 6, 211–236.

    Google Scholar 

  • Lewis, J. R. (1994). Patient views on quality care in general practice. Social Science and Medicine, 39, 655–670.

    Google Scholar 

  • Lifton, R. J. (1978). Advocacy and corruption in the healing profession. In C. R. Figley (Ed.), Stress disorders among Vietnam veterans (pp. 209–230). New York: Brunner/Mazel.

    Google Scholar 

  • Marshall, G., Hays, R., Sherbourne, C., & Wells, K. (1993). The structure of patient satisfaction with outpatient medical care. Psychological Assessment, 4, 477–483.

    Google Scholar 

  • McIver, S., & Carr-Hill, R. (1989). The NHS and its customers. York, England: University of York.

    Google Scholar 

  • Moos, R. H. (1988). Community Oriented Programs Environment Scale manual (2nd ed.). Palo Alto, CA: Consulting Psychologists Press.

    Google Scholar 

  • Moos, R. H., & Moos, B. S. (1998). The staff workplace and the quality and outcome of substance abuse treatment. Journal of Studies on Alcohol, 59, 43–51.

    Google Scholar 

  • Muthen, L. K., & Muthen, B. O. (1998). Mplus user's guide. Los Angeles: Authors.

    Google Scholar 

  • Pekarik, G., & Wolff, C. B. (1996). Relationship of satisfaction to symptom change, follow-up adjustment, and clinical significance. Professional Psychology: Research and Practice, 27, 202–208.

    Google Scholar 

  • Pellino, T. A., & Ward, S. E. (1998). Perceived control mediates the relationship between pain severity and patient satisfaction. Pain Symptom Management, 15, 110–116.

    Google Scholar 

  • Plichta, S. B., Duncan, M. M., & Plichta, L. (1996). Spouse abuse, patient–physician communication, and patient satisfaction. American Journal of Preventive Medicine, 12, 297–303.

    Google Scholar 

  • Rey, J. M., Plapp, J. M., & Simpson, P. L. (1999). Parental satisfaction and outcome: A 4-year study in a child and adolescent mental health service. Australian and New Zealand Journal of Psychiatry, 33, 22–28.

    Google Scholar 

  • Rosenheck, R., & Fontana, A. (1996). Treatment of veterans severely impaired by posttraumatic stress disorder. In R. J. Ursano & A. E. Norwood (Eds.), Emotional aftermath of the Persian Gulf war (pp. 501–532). Washington, DC: American Psychiatric Press.

    Google Scholar 

  • Rosenheck, R., Fontana, A., & Errera, P. (1997). Inpatient treatment of war-related posttraumatic stress disorder: A 20-year perspective. Journal of Traumatic Stress, 10, 407–413.

    Google Scholar 

  • Rosenheck, R. A., Fontana, A., & Stolar, M. (1999). Assessing quality of care: Administrative indicators and clinical outcomes in posttraumatic stress disorder. Medical Care, 37, 180–188.

    Google Scholar 

  • Rosenheck, R., Wilson, N. J., & Meteroko, M. (1997). Influence of patient and hospital factors on consumer satisfaction with inpatient mental health treatment. Psychiatric Services, 48, 1553–1561.

    Google Scholar 

  • Rosenthal, G. E., & Shannon, S. E. (1997). The use of patient perceptions in the evaluation of health-care delivery systems. Medical Care, 35(Suppl.), NS58-NS68.

    Google Scholar 

  • Sherbourne, C., Sturm, R., & Wells, K. B. (1999). What outcomes matter to patients? Journal of General Internal Medicine, 14, 357–363.

    Google Scholar 

  • Sitzia, J., & Wood, N. (1997). Patient satisfaction: A review of issues and concepts. Social Science and Medicine, 45, 1829–1843.

    Google Scholar 

  • Sixma, H. J., Spreeuwenberg, P. M., & van der Pasch, M. A. (1998). Patient satisfaction with the general practitioner: A two-level analysis. Medical Care, 36, 212–229.

    Google Scholar 

  • Svensson, B., & Hansson, L. (1994). Patient satisfaction with inpatient psychiatric care. The influence of personality traits, diagnosis and perceived coercion. Acta Psychiatrica Scandinavia, 90, 379–384.

    Google Scholar 

  • Williams, B. (1994). Patient satisfaction: A valid concept? Social Science and Medicine, 38, 509–516.

    Google Scholar 

  • Williams, B., Coyle, J., & Healy, D. (1998). The meaning of patient satisfaction: An explanation high reported levels. Social Science and Medicine, 47, 1351–1359.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of the VA National Center for PTSD, Connecticut Healthcare System, Northeast Program Evaluation Center, West Haven, Connecticut

    Robert Rosenheck

  2. Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut

    Alan Fontana & Robert Rosenheck

  3. Department of Psychiatry, University of Connecticut Health Center, Farmington, Connecticut

    Julian D. Ford

Authors
  1. Alan Fontana
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Julian D. Ford
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Robert Rosenheck
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alan Fontana.

About this article

Cite this article

Fontana, A., Ford, J.D. & Rosenheck, R. A Multivariate Model of Patients' Satisfaction with Treatment for Posttraumatic Stress Disorder. J Trauma Stress 16, 93–106 (2003). https://doi.org/10.1023/A:1022071613873

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1022071613873

Search

Navigation