Abstract
The aim of this cross-sectional study was to assess factors associated with client satisfaction in two mental health outpatient settings in Italy and the US. Sociodemographic and clinical variables, hope, and personality characteristics were evaluated in 18–65-year-old patients who had been receiving services for at least 2 months in one of two outpatient clinics, in Italy and the US. Patients were administered: the Healthy Days Core Module, the Kessler Screening Scale for Psychological Distress, the Verona Service Satisfaction Survey, the Client Satisfaction Inventory, the Health Service OutPatient Experience questionnaire, the Herth Hope Index, and the NEO Five-Factor Inventory-3. Bivariate tests for differences between the two samples were conducted, a Satisfaction Composite z-score was computed, and a stepwise, backward elimination, multiple linear regression model—including the variables that were significantly associated with Satisfaction Composite Score in bivariate tests—was built. From July 1, 2015 to April 30, 2016, 184 patients (121 in Foligno, 63 in New York City) were enrolled in the study. Predictors of client satisfaction included: receiving services in New York City, being older, having lower educational attainment, having inner positive readiness and expectancy as well as interconnectedness with self and others, and high scores on the agreeableness personality domain. Interestingly, diagnosis and treatment characteristics did not influence satisfaction. Client satisfaction with outpatient mental health services is mainly influenced by sociodemographic characteristics and personality factors more than clinical variables or patterns of care. These findings could have implications regarding trends toward value-based payment models.
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Ackerman, P. L., & Cianciolo, A. T. (2000). Cognitive, perceptual-speed, and psychomotor determinants of individual differences during skill acquisition. Journal of Experimental Psychology: Applied, 6(4), 259–290.
Barbaranelli, C. (2002). Evaluating cluster analysis solutions: an application to the Italian NEO personality inventory. European Journal of Personality, 16(S1), S43–S55.
Bigatti, S. M., Cronan, T. A., Grove, M., Groessl, E., & Tomita, M. (1997). Predictors of health care satisfaction among older people with osteoarthritis. Mind Body Medicine, 2(2), 112–120.
Bleich, S. N., Özaltin, E., & Murray, C. J. (2009). How does satisfaction with the health-care system relate to patient experience? Bulletin of the World Health Organization, 87, 271–278.
Breemhaar, B., Visser, A. P., & Kleijnen, J. G. (1990). Perceptions and behaviour among elderly hospital patients: Description and explanation of age differences in satisfaction, knowledge, emotions and behaviour. Social Science & Medicine (1982), 31(12), 1377–1385.
Catanesi, R., Manna, A., Ventriglio, A., & Schizoph, E. (2016). Community mental health services and responsibility of psychiatrists in Italy: Lessons for the globe. Social Psychiatry, 62(6), 501–504.
Cendon, P. (2015). La responsabilità dei servizi psichiatrici - Paolo Cendon - Libro - Key Editore - Saggi | IBS. Key Editore.
Chue, P. (2006). The relationship between patient satisfaction and treatment outcomes in schizophrenia. Journal of Psychopharmacology, 20(6 suppl), 38–56.
Coluccia, A., Ferretti, F., & Pozza, A. (2014). Health Services OutPatient Experience questionnaire: Factorial validity and reliability of a patient-centered outcome measure for outpatient settings in Italy. Patient Related Outcome Measures, 5, 93–103.
Costa, P. T., & McCrae, R. R. (2010). Bridging the gap with the five-factor model. Personality Disorders: Theory, Research, and Treatment, 1(2), 127–130.
Cruz, L., Kline, E., Seidman, L., & Minor, K. (2016). Longitudinal determinants of client treatment satisfaction in an intensive first-episode psychosis treatment programme. Early Intervention in Psychiatry, 11, 354–362.
Eklund, M. (2001). Determinants of satisfaction with community-based psychiatric services: A cross-sectional study among schizophrenia outpatients. Nordic Journal of Psychiatry, 55(6), 413–418.
Gigantesco, A., Picardi, A., Chiaia, E., Balbi, A., & Morosini, P. (2002). Patients’ and relatives’ satisfaction with psychiatric services in a large catchment area in Rome. European Psychiatry, 17, 139–147.
Greenley, J., Young, T., & Schoenherr, R. (1982). Psychological distress and patient satisfaction. Medical Care, 20, 373–385
Hagerty, M. R., Cummins, R. A., Ferriss, A. L., Land, K., Michalos, A. C., Peterson, M., Sharpe, A., et al. (2001). Quality of life indexes for national policy: Review and agenda for research. Social Indicators Research, 55(1), 1–96.
Hendriks, A. A. J., Smets, E. M. A., Vrielink, M. R., Van Es, S. Q., & De Haes, J. C. J. M. (2005). Is personality a determinant of patient satisfaction with hospital care? International Journal for Quality in Health Care 18(2), 152–158.
Herth, K. (1992). Abbreviated instrument to measure hope: Development and psychometric evaluation. Journal of Advanced Nursing, 17(10), 1251–1259.
Hubbeling, D., & Bertram, R. (2014). Hope, happiness and home treatment: A study into patient satisfaction with being treated at home. Psychiatric Bulletin, 38(6), 265–269.
Hughes, J. R., Clark, S. E., Wood, W., Cakmak, S., Cox, A., MacInnis, M., Warren, B., et al. (2010). Youth homelessness: The relationships among mental health, hope, and servic…: Discovery Service for Columbia University Libraries. Journal of the Canadian Academy of Child & Adolescent Psychiatry, 19(4), 274–283.
Jaipaul, C. K., & Rosenthal, G. E. (2003). Are older patients more satisfied with hospital care than younger patients? Journal of General Internal Medicine, 18(1), 23–30.
Kane, R. L., Maciejewski, M., & Finch, M. (1997). The relationship of patient satisfaction with care and clinical outcomes. Medical Care, 35(7), 714–730.
Kessler, R., Andrews, G., & Colpe, L. (2002). Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychological Medicine, 32(6), 959–976.
Kessler, R. C., Barker, P. R., Colpe, L. J., Epstein, J. F., Gfroerer, J. C., Hiripi, E., Howes, M. J., et al. (2003). Screening for serious mental illness in the general population. Archives of General Psychiatry, 60(2), 184.
Lally, J., Byrne, F., McGuire, E., McDonald, C., Attkisson, C. C., Zwick, R., Barak, Y., et al. (2013). Patient satisfaction with psychiatric outpatient care in a university hospital setting. Irish Journal of Psychological Medicine, 30(4), 271–277.
McMurtry, S., & Hudson, W. (2000). The Client Satisfaction Inventory: Results of an initial validation study. Research on Social Work Practice, 10, 644–663.
Mitchell, C. M., & Beals, J. (2011). The utility of the Kessler Screening Scale for Psychological Distress (K6) in two American Indian communities. Psychological Assessment, 23(3), 752–761.
Moriarty, D. G., Zack, M. M., & Kobau, R. (2003). The Centers for Disease Control and Prevention’s healthy days measures—Population tracking of perceived physical and mental health over time. Health and Quality of Life Outcomes, 1(1), 37.
Peuskens, J. (2004). Clinical effectiveness in adults with chronic schizophrenia. European Neuropsychopharmacology, 14, S453–S459.
Quintana, J. M., González, N., Bilbao, A., Aizpuru, F., Escobar, A., Esteban, C., San-Sebastián, J. A., et al. (2006). Predictors of patient satisfaction with hospital health care. BMC Health Services Research, 6, 102.
Rahmqvist, M. (2001). Patient satisfaction in relation to age, health status and other background factors: A model for comparisons of care units. International Journal for Quality in Health Care, 13(5), 385–390.
Rahmqvist, M., & Bara, A.-C. A. (2010). Patient characteristics and quality dimensions related to patient satisfaction. International Journal for Quality in Health Care, 13, 257–264.
Ripamonti, C. I., Buonaccorso, L., Maruelli, A., Bandieri, E., Pessi, M. A., Boldini, S., Primi, C., et al. (2012). Patient dignity inventory (PDI) questionnaire: The validation study in Italian patients with solid and hematological cancers on active oncological treatments. Tumori, 98(4), 491–500.
Rockville. (2001). A supplement to Mental health: A report of the Surgeon General. Mental Health: Culture, Race, and Ethnicity. U.S. Department of Health and Human Services.
Ruggeri, M. (1994). Patients’ and relatives’ satisfaction with psychiatric services: The state of the art of its measurement. Social Psychiatry and Psychiatric Epidemiology, 29(5), 212–227.
Ruggeri, M., Lasalvia, A., Bisoffi, G., Thornicroft, G., Vàzquez-Barquero, J. L., Becker, T., Knapp, M., et al. (2003). Satisfaction with mental health services among people with schizophrenia in five European sites: results from the EPSILON Study. Schizophrenia Bulletin, 29(2), 229–245.
Serber, E. R., Cronan, T. A., & Walen, H. R. (2003). Predictors of patient satisfaction and health care costs for patients with fibromyalgia. Psychology & Health, 18(6), 771–787.
Sharpe, J. P., Martin, N. R., & Roth, K. A. (2011). Optimism and the big five factors of personality: Beyond neuroticism and extraversion. Personality and Individual Differences, 51(8), 946–951.
Shaw, W. S., Cronan, T. A., Lee, R. E., & Kaplan, R. M. (1996). Health care satisfaction among osteoarthritis sufferers. Psychology & Health, 11(3), 395–409.
Sousa, V. D., & Rojjanasrirat, W. (2011). Translation, adaptation and validation of instruments or scales for use in cross-cultural health care research: A clear and user-friendly guideline. Journal of Evaluation in Clinical Practice, 17(2), 268–274.
Terranova, C., & Sartore, D. (2013). Suicide and psychiatrist’s liability in Italian law cases. Journal of Forensic Sciences, 58(2), 523–526.
Van Gestel-Timmermans, H., Van Den Bogaard, J., Brouwers, E., Herth, K., & Van Nieuwenhuizen, C. (2010). Hope as a determinant of mental health recovery: A psychometric evaluation of the Herth Hope Index-Dutch version. Scandinavian Journal of Caring Sciences, 24, 67–74.
Vogus, T. J., & McClelland, L. E. (2016). When the customer is the patient: Lessons from healthcare research on patient satisfaction and service quality ratings. Human Resource Management Review, 26(1), 37–49.
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Pauselli, L., Galletti, C., Verdolini, N. et al. Predictors of Client Satisfaction with Outpatient Mental Health Clinic Services in Italy and New York. Community Ment Health J 54, 562–570 (2018). https://doi.org/10.1007/s10597-017-0196-6
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DOI: https://doi.org/10.1007/s10597-017-0196-6