PROMs may differ little from traditional instruments unless they truly incorporate the patient's perspective and not just the perspectives of clinicians and researchers. Efforts to develop new PROMs that provide a more patient-centred outcome assessment should use qualitative and participatory methods to capture and incorporate patient perspectives and values.

BackgroundSatisfaction with services represents a key component of the user’s perspective, and user satisfaction surveys are the most commonly used approach to evaluate the aforementioned perspective. The aim of this discursive paper is to provide a critical overview of user satisfaction surveys in addiction treatment and harm reduction services, with a particular focus on opioid maintenance treatment as a representative case.MethodsWe carried out a selective critical review and analysis of the literature on user satisfaction surveys in addiction treatment and harm reduction services.ResultsMost studies that have reported results of satisfaction surveys have found that the great majority of users (virtually all, in many cases) are highly satisfied with the services received. However, when these results are compared to the findings of studies that use different methodologies to explore the patient’s perspective, the results are not as consistent as might be expected. It is not uncommon to find that “highly satisfied” patients report significant problems when mixed-methods studies are conducted. To understand this apparent contradiction, we explored two distinct (though not mutually exclusive) lines of reasoning, one of which concerns conceptual aspects and the other, methodological questions.ConclusionUser satisfaction surveys, as currently designed and carried out in addiction treatment and harm reduction services, do not significantly help to improve service quality. Therefore, most of the enthusiasm and naiveté with which satisfaction surveys are currently performed and interpreted – and rarely acted on in the case of nonoptimal results – should be avoided. A truly participatory approach to program evaluation is urgently needed to reshape and transform patient satisfaction surveys.

The results of this study are consistent with the extensive literature that confirms the predictor power of self-efficacy. Unexpectedly, it did not find independent positive relationships between other psychological variables and abstinence. Given that self-efficacy can predict outcome in the medium term, it is suggested that treatment could target this variable.

Considering the importance of coping strategies and resilience in adapting to the stress caused by cancer, the objective of this research is to explore which coping strategies are the most used, in order to know whether different groups of levels of resilience and an appropriate coping style are related to a higher quality of life and better adaptation to the disease. There were 74 participants with cancer in this study (79.7% of them were women) ranging in age from 29 to 85 years ( M = 50.9). Different instruments were used to measure the resilience construct (ER-20 items Resilience Scale), coping strategies (Cognitive Emotion Regulation Questionnaire-Short) and quality of life (General Health Questionnaire). People with higher resilience showed higher scores in the use of adaptive strategies, being acceptance and positive revaluation the most frequent ones. Regarding perception of quality of life, people with lower resilience showed statistically significant differences in the dimensions of pain and general health, which were likewise the most common ones for people with lower resilience. A significant association has been demonstrated between resilience and an adaptive coping, which at the same time are positively linked to quality of life of people with cancer. This study provides information about how different groups of resilience levels are related with coping and quality of life in people with cancer. It could be useful information for psychologists in the oncological area who have to take decisions in the clinical context. A practical consequence would involve trying to modify the type of coping, as well as increasing the level of resilience in people with cancer, in order to achieve a better adjustment to the disease.

In this paper, the findings of an I þ D þ i research are presented. In this study, an analysis was conducted to assess 14 educational centers where in one of two distinct quality systems had been implemented: the EFQM (European Foundation Quality Management) and el Proyecto de Calidad Integrado (PCI)-the Integrated Quality Project-promoted by the Horrêum Foundation (Alvarez and Santos, 2003; Villa and Marauri, 2004). The EFQM was first used by businesses before being recently transferred to the academics. It comprised nine factors that were translated in an educational context: leadership, policy and strategy, people, alliances and resources, processes, impact on people, impact on clients, impact on society, and key impacts of an organization. The first five factors examine the way activities are carried out and improved, and the final four focus on the impact, i.e., the effect of the organization's activities. Improvement is achieved through learning and innovation. The PCI (Muñoz and Sarasúa, 2005) has its educational origins in the Effective School Improvement model. Seven factors are analyzed (Sarasola et al., 2003; Villa et al., 2004): institutional approach, organizational structures, relationships and living together, counseling and tutoring, curriculum, family and the community (Martínez and Galíndez, 2003), and management and services. The study looks at the impact that the two aforementioned quality systems (EFQM and PCI) have had on educational centers. The term "impact" is understood as the changes experienced both inside and outside an educational center. It must be sustainable overtime, considering the changes and effects achieved, as evidence of improvement. The quantitative analysis focuses on two dimensions. The first addresses three key factors of educational policy: educational planning, communication, and support and rewards for teachers. The second comprises three factors linked to management processes in educational institutions: organizational climate, teaching and learning processes, and relationships with the community.