ABSTRACT

This study analyzed data from an existing hospital birthing center patient satisfaction survey to determine which care factors were most important to patients and correlated with the likelihood to recommend the facility to others. Three dimensions of care emerged--wait time, communication, and service. Patients gave lower scores for satisfaction if they waited longer than expected for a call light response: 40% of patients expected to wait 4 minutes or less for a response. Discussing with patients realistic wait times for call light responses may be a way to improve patient satisfaction.

IntroductionChronic disease studies have omitted analyses of the American Indian/Alaska Native (AI/AN) population, relied on small samples of AI/ANs, or focused on a single disease among AI/ANs. We measured the influence of income, employment status, and education level on the prevalence of chronic disease among 14,632 AI/AN elders from 2011 through 2014.MethodsWe conducted a national survey of AI/AN elders (≥55 y) to identify health and social needs. Using these data, we computed cross-tabulations for each independent variable (annual personal income, employment status, education level), 2 covariates (age, sex), and presence of any chronic disease. We also compared differences in values and used a binary logistic regression model to control for age and sex.ResultsMost AI/AN elders (89.7%) had been diagnosed with at least one chronic disease. AI/AN elders were also more than twice as likely to have diabetes and more likely to have arthritis. AI/AN elders with middle-to-low income levels and who were unemployed were more likely to have a chronic disease than were high-income and employed AI/AN elders.ConclusionAddressing disparities in chronic disease prevalence requires focus on more than access to and cost of health care. Economic development and job creation for all age cohorts in tribal communities may decrease the prevalence of long-term chronic diseases and may improve the financial status of the tribe. An opportunity exists to address health disparities through social and economic equity among tribal populations.

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Persistent shortages of special education teachers, particularly in rural areas, exist across the country. This study assessed the openness of teacher candidates enrolled in an introductory education course at two rural Midwest universities to a special education career path. Survey findings confirmed that work or volunteer experience involving people with special needs is a significant predictor of choosing special education as a career path. Findings also revealed that not all students who have experience with individuals with special needs choose to pursue special education. Considerations for teacher education faculty hoping to attract more special educators to the field are discussed.