Satisfaction with care among low-income female outpatients

Abstract

Patient satisfaction correlates with important health behaviors and outcomes. Little is known about satisfaction in disadvantaged populations of different racial/ethnic backgrounds. The current study evaluated demographic and psychological correlates of patient satisfaction among a low-income, multiethnic sample of female outpatients attending cervical cancer screening. Participants included 338 African American, Latina, and white women ages 18 - 49 years attending University of Texas Medical Branch Regional Maternal & Child Health Clinics. Data were obtained via self-report and chart review. Patient satisfaction was assessed using the Patient Satisfaction Questionnaire (PSQ). Total PSQ scores reflected two distinct underlying subscales (satisfaction and dissatisfaction), which differed from the original factor structure of the PSQ. Satisfaction was predicted by patient beliefs that their health is self-determined, beliefs that doctors control their health, self-esteem, and education. Dissatisfaction was predicted by patient beliefs that good health is a matter of chance/luck, self-esteem, social desirability, and income. Higher self-esteem, education, and beliefs that health is controlled by oneself or doctors correlated with higher satisfaction with care in the clinic setting. Understanding the influence of patient characteristics on perceptions of care is important for physicians to foster relationships with patients that increase feelings of satisfaction, decrease dissatisfaction, and ultimately, improve health outcomes.

Examining Breast Cancer Screening Barriers Among Central American and Mexican Immigrant Women: Fatalistic Beliefs or Structural Factors?

“…The construct of health locus of control describes the extent to which an individual attributes responsibility for both health and illness to chance, powerful others such as God or doctors, or self (Navarro Rubio, Pearson, Clark, & Breitkopf, 2007). Internal health locus of control is commonly associated with higher self-efficacy and health promoting behaviors, while external control is thought to encourage passivity and avoidance of health promoting behaviors, leading to poorer health outcomes (Franklin et al, 2007;Roncancio, Berenson, & Rahman, 2012).…”

Hispanic Women's Health Care Provider Control Expectations: The Influence of Fatalism and Acculturation

“…The powerful others health locus of control (PHLC) is a dimension of HLC that measures the extent to which other people control one's health. 7–9 A component of the PHLC dimension is health care provider (HCP) control expectations. This measures the extent to which individuals believe that their HCPs have control over their health.…”

“…7 For example, HIV patients who were adherent with their treatment regimens scored higher on the HCP control expectation items than non-adherent patients. 8 We also know that HCPs' recommendations positively influence Hispanic patients' breast cancer screening rates 9 and that patients' perceptions of their HCPs predict their satisfaction with care and their adherence to HCP recommendations.…”

Evaluation of a Professional Practice Model in the Ambulatory Care Setting

“…Given that, in part, alpha is a function of the number of items; unless there is a substantive correlation between two items, a two-item scale will tend to manifest lower reliability scores. After reviewing the literature and conferring with the statistician, an ad-hoc analysis using exploratory factor analysis, reflected a two factor solution similar to that obtained by Rubio, Pearson, Clark, and Breitkopf (2007). Specifically, the items aligned along a positive or negative axis, indicating satisfaction or dissatisfaction.…”