Patient Satisfaction in Chamber Setting

diligent Satisfaction in Chamber SettingPatient Satisfaction in Chamber Setting in Bangladesh deliberate by Patient-Doctor kinship Questionnaire (PDRQ-9 Bangla)AbstractBackground Assessment of diligent felicity is crucial but in that location is significant lagging in this sector. Patient cheer is an important indicator of wellness care quality as well as a predictor of treatment adherence. The Good diligent-doctor race is considered as an inherent part of the patient satisfaction. In Bangladesh, this domain is yet to be explored in a large scale.Aim It was aimed to look into the patient satisfaction level in chamber setting in Bangladesh measured using the patient-doctor human kinship questionnaire (PDRQ-9 Bangla).Methods PDRQ-9 is a short yet excellent tool for assessing the patient-doctor relationship. The data collection was done in private chamber setting by the PDRQ-9 and analyzed.Results Though the result was non completely in line with the existing books, the P DRQ-9 was frame to a useful and design measurement tool in the con school text of the patient-doctor relationship.Conclusion Large-scale research in this particular aspect of patient satisfaction in future may provide a more succinct result.Keywords PDRQ-9 Bangla, Patient Satisfaction, Chamber Practice, Doctor-Patient, Bangladesh.IntroductionBeing as old as the civilization the field of medicament is evolving rapidly 1 but there is a significant lagging in the assessment of patient satisfaction which is considered as equ solelyy important as other health measures and a significant indicator of efficiency of health care delivery 2. As stated by Lender et al. patient satisfaction may be defined as positive evaluations of distinct dimensions of health care 3. A parallel interaction is present in between patient satisfaction, continuity of care, availability of treatment and physician, as patient prefer the availability and accessibility of the same physician. The measurement of p atient satisfaction is thus useful is assessing the quality of care and in any case subsequent health-related behaviors and adherence to treatment, at the same sequence knowing the patient priorities would facilitate the improvement of patient experience 4,5. Thus patient satisfaction dexterity be considered as an indicator of institutional performance as well as patients wish to become more compliance and recommendation for others, which are all related to the socio-demographic condition, the health status of community and more over Patient-Doctor Relationship 6,7,8.Patient-Doctor Relationship, a dynamic, vital yet complex interpersonal relationship which has been put under the microscope for quite a long over the century and this mutual relationship is intermingled with the idea of patient satisfaction, compliance with treatment and eventually effort the treatment come oncome 9. Over the time the concept of patient-doctor relationship has evolved a lot and currently, patient -centeredness is the most preferred by the patients hence the health care provider focuses of patient autonomy and more emphasis over patient satisfaction 10, 11, 12. Despite being widely advocated, the practicality of patient-centered model is yet under consideration on the butt of time constraint in consultation as the physician has to perform the daunting task of providing comprehensive, coordinated yet satisfactory to the patient and in a higher place all make sure the accessibility of the care 13, 14. Whether being psychiatric or non-psychiatric patient it is reported that successful and both way, a perfect relationship between patient and physician is crucial for the adherence and better outcome of treatment 15.For assessing the patient-doctor relationship, a legal brief, concise yet having excellent psychometric characteristics scale has been genuine and validated known as the 9-item patient -doctor relationship questionnaire (PDRQ-9) 14,15,16, 17,18 which essentially eval uates the therapeutic aspect of the patient-doctor relationship based on the perspective of the patient in the indigenous health care setting 14,15. PDRQ-9 gives the opportunity to quantify the communication, level of satisfaction and availability in dealing with the physician in regard to patients point of view 18. Initially validated by Van der Feltz-Cornelis et al. this is to be reported that there is internal consistency among the items of the scale 17 and later was to validated by multiple researchers 14,15,16,18.Bangladesh, a developing country having about 160 million people and achieving the health-related goal of MDG but lacking significantly in regard to abstract similarity in health services between physician and patients, hence there exists violence against the doctor and lack of compliance with treatment and eventually patient satisfaction 1,9,19-20. But unfortunately, there is little to be pitch in terms of literature regarding the patient satisfaction and patient-d octor relationship. So the authors aimed to look into the patient satisfaction level in public hospital and private chamber setting in Bangladesh measured using the patient-doctor relationship questionnaire (PDRQ-9 Bangla).MethodsSetting The data collection part was carried out in 3 different hospitals by 3 different physicians.Instrument The Bangla version of 9 item based Patient-Doctor Relationship Questionnaire (PDRQ-9) was used as the tool for questioning patients which have 5 points Likert-type scale from 1 non at all appropriate, to 5 all appropriate.Design and Subject The study was carried out in the outpatient department of Dhaka Medical College and some private chambers in the city of Dhaka over the period of January 2016 to December 2016 from 214 patients with the Bangla version of Patient-Doctor Relationship Questionnaire (PDRQ-9) with purposive sampling. The filling out of the questionnaire was totally voluntary and completed by the participant themselves and assistan ce weas provided to respondents who were not able to understand any question. Patients who were willing to come in and able to understand Bangla were included in the study and patients who were not willing were excluded. After proper collection of data, the analysis was done by SPSS 16 and Microsoft pass 2010.Data Collection Method Self-reporting PDRQ-9 Bangla questionnaire and providing assistance when the patient could not understand the questionnaire.ResultsTable 1 VM1Demographic VariablesAgeCompleted old age percentage sexualityGender percentage14-2529.3Male40.226-3526.9Female59.836-4520.7ReligionReligionPercent46-5510.7Islam9356-6511.7Sanatan7Mean SD (Range)37 9.92Marital SituationStatusPercentResidenceAreaPercentUn marry19.9Urbane57.8Married78.7Suburban14.3Widow0.5Village28Divorced0.5Educational QualificationStatusPercentOccupationStatusPercentBelow SSC40.9Student32.2SSC16.2Service Holder16.4HSC18.8Business7.5Graduation/ Equivalents12.3Housewife23.8Post graduation11.7Other s7.9Monthly Family IncomeTakaPercentFamilyFamily vitrinePercent1.73Nuclear52.85000-1000010.98Joint Family45.810000-1500015.0315000-2000012.1420000-2500013.2925000-3000024.283000021.97Demographic Picture of the Respondents. In this study, authors considered age, gender, religion, residence, educational qualification, monthly income, marital status, occupation and family type as demographic variables. Age of the respondents was found Mean SD (Range) 37 9.92 (14-65) years 40.2 % respondents were male and 59.8% female 57.8% resided in urban area where as 14.3% in suburb and 28 % in village 78.7% were married and 19.9% were unmarried 52.8% belonged to nuclear family and 45.8% were from joint family (Table 1).Table 2 Level of satisfaction in regards to item wise responses (n=214)StatisticsQ-1Q- 2Q- 3Q- 4Q-5Q- 6Q- 7Q- 8Q-9Mean4.294.354.504.174.444.234.314.283.86Median555444.5554Mode555555555Std. Deviation0.990.990.850.973.530.911.021.061.17Minimum111111111Maximum555555555The level of sat isfaction among the Respondents. Among the 9-items of the PDRQ-9, there was a usual trend of the mean being about 4.17 to 4.50. The lowest mean was found in the 9th question I find my physician slowly accessible which was 3.86. I trust my physician the 3rd item had the highest mean of 4.50. The Standard deviation for the items was around 0.99 to 3.53. 5th question My physician is dedicated to table service me had the highest standard deviation of 3.53 (Table 2).Table 3 Distribution of responses of PDRQ-9 Bangla itemsnot at all appropriatesomewhat appropriateappropriatemostly appropriatetotally appropriateTotalItemF (%)F (%)F (%)F (%)F (%)F (%)Q 14 (1.87)11 (5.14)26 (12.15)51 (23.83)122 (57.01)214 (100)Q 22 (.93)16 (7.48)20 (9.35)43 (20.09)133 (62.15)214 (100)Q 33 (1.40)3 (1.40)24 (11.21)37 (17.29)147 (68.69)214 (100)Q 44 (1.87)10 (4.76)30 (14.02)71 (33.18)99 (46.26)214 (100)Q 52 (.93)15 (7.01)22 (10.28)71 (33.18)103 (48.13)214 (100)Q 62 (.93)6 (2.80)40 (18.69)59 (27.57)107 (50)21 4 (100)Q 73 (1.40)17 (7.96)19 (8.88)47 (21.96)128 (59.81)214 (100)Q 86 (2.80)14 (6.54)20 (9.35)49 (22.90)125 (58.41)214 (100)Q 98 (3.74)19 (8.88)58 (27.10)39 (18.22)90 (42.06)214 (100)Distribution of responses. Among all the 9 items and 5 responses, there was an overall tendency of answering the 5th option totally appropriate by the respondents as evident by the frequency ranging from 42.06% to 68.69% which were the highest for all the 9-items. Not at all appropriate had the lowest frequency ranging around 0.93% to 3.74%. Other three options had all most equal distribution though a greater tendency for the mostly appropriate was discover (Table 3).DiscussionPatient-Doctor Relationship is a strong indicator of patient satisfaction as well as the predictor of treatment adherence and quality of health care. Patient satisfaction, on the other hand, depends largely on the availability of care and caregiver. Patient-Doctor Relationship Questionnaire-9 (PDRQ-9) is a brief and excellent to ol for assessing the quality of patient-doctor relationship on the regards of patients experience and therefore a useful instrument for measuring patient satisfaction. primarily developed by Van Der Feltz-Cornelis et al. in 2004 it was based on Helping Alliance Questionnaire of Luborsky (HAQ), a scale that measures the therapeutic alliance in psychotherapy 17. Later, legion(predicate) attempts were taken to validate PDRQ-9 in different languages. In Adan et al. validated the Spanish version and Mergen et al. in 2012 validated the Turkish version, in 2014 Zenger et al. validated the German version of PDRQ-9 and in 2016 Arafat validated the Bangla version which was the tool for this particular study 16, 17, 18, 21, 22.On demographic basis Age of the respondents was found Mean SD (Range) 37 9.92 (14-65) years which was close enough to the Bangla trial impression study where Age of the respondents was found as mean SD (range) 35.6 10.71 and also with Nigerian version where mean ag e was 40.12 but not consistent with the German validation where Mean age was 50.58 for men and 50.87 for women and also in this particular study 52.8% respondents belonged to nuclear family and 45.8% were from joint family which also aligned with the Bangla validation study where 52% had nuclear family and 48% belonged to joint family environment 16, 18. 40.2 % respondents were male and 59.8% female which was not in line with the Bangla version where 62% were male and 38% were female but was close to the Nigerian validation where male sex frequency was 47.6% and the female was 52.4%15, 18.The origin of the respondents which in this study was 57.8% from an urban area where as 14.3% from suburb and 28 % from the village, but in the Bangla Validation version 64% lived in town, 16% in mini town, and 20% in the village 18.On the 9-items the Mean was found 4.29, 4.35, 4.50, 4.17, 4.44, 4.23, 4.31, 4.28 and 3.86 respectively which were not consistence with either the original Dutch or late r validated Spanish, Turkish, Nigerian or Bangla version 15,17, 18, 22 but the German Validation study showed means of the 9-items which were almost similar to this study16. It was seemed to be found that the respondents chose to answer mostly appropriate in this particular study.However, as observed by Arafat SMY most of the people in Bangladesh has the perception that, the role of the physicians here are motivated by financial gain only and thus not fully justified which often lead to violence against doctor as well as the health services providers which do not completely break down with the result of this particular study 9. Also, the doctor leads a hectic life in this country and the overwhelming number of patients per physician also make it toilsome to provide quality and patient-centered care 1. The overall result of the study might not reflect the picture on basis of the currently available literature in this context.Limitations of the StudyThe majority of the data was coll ected from private chamber setting which might have been the cause of a result not in line with the other articles. Moreover, in some respondents assistance was provided to fill out the questionnaire.ConclusionThe result from the analysis indicated a better level of satisfaction among the patients which was not quite in line with the premeditated concept of the authors as it did not fall in line with the available data. Despite this fact, the Bangla validated the version of PDRQ-9 was found as a very helpful as an instrument for assessing the relationship between patient and doctor in a very short time and both in public and private health care facility. As the scale bears only patients perspective it was very proficient for measuring patient satisfaction. In a developing country like Bangladesh, future large-scale studies to substantiate the findings of this particular study and further evaluate the patient satisfaction on the basis of patient-doctor relationship may provide a clea rer picture.References 1. Andalib A, Arafat SMY. Practicing Pattern of Physicians in Bangladesh. International Journal of Perceptions in Public Health. 20161(1)9-13.2. Linda .MS P, editor. PATIENT SATISFACTION SURVEYS FOR CRITICAL ACCESS HOSPITALS. inaugural ed. 1607 West Jefferson Street Boise, Idaho 82702 2001.3. Linder-Pelz S. Toward a theory of patient satisfaction. Social Science Medicine. 1982 Jan16(5)577-82.4. Raivio R, Jskelinen J, Holmberg-Marttila D, Mattila KJ. Decreasing trends in patient satisfaction, accessibility and continuity of care in Finnish primary health care a 14-year follow-up questionnaire study. BMC Family Practice. 2014 May 1515(1).5. Paddison CAM, Abel GA, Roland MO, Elliott MN, Lyratzopoulos G, Campbell JL. Drivers of overall satisfaction with primary care Evidence from the English widely distributed practice patient survey. Health Expectations. 2013 May 3018(5)1081-92.6. Kon Pfoyo AJ, Wodchis WP. Organizational performance impacting patient satisfac tion in Ontario hospitals A multilevel analysis. BMC Research Notes. 20136(1)509.7. capital of Mississippi JL, Chamberlin J, Kroenke K. Predictors of patient satisfaction. Social Science Medicine. 2001 Feb52(4)609-20.8. Rahmqvist M, Bara A. Patient characteristics and quality dimensions related to patient satisfaction. International Journal for Quality in Health Care. 2010 Feb 322(2)86-92.9. Arafat SMY. Doctor Patient Relationship an Untouched Issue in Bangladesh. International Journal of Psychiatry. 2016 Jul 161(1)2.10. Kaba R, Sooriakumaran P. The evolution of the doctor-patient relationship. International Journal of Surgery. 2007 Feb5(1)57-65.11. Ridd M, Shaw A, Lewis G, Salisbury C. The patient-doctor relationship A synthesis of the qualitative literature on patients perspectives. British Journal of General Practice. 2009 Apr 159(561)116-33.12. Bensing JM, Tromp F, van Dulmen S, van den Brink-Muinen A, Verheul W, Schellevis FG. Shifts in doctor-patient communication between 198 6 and 2002 A study of videotaped general practice consultations with hypertension patients. BMC Family Practice. 2006 Oct 257(1).13. Little P, Everitt H, Williamson I, Warner G, Moore M, Gould C, Ferrier K, Payne S. Observational study of effect of patient centredness and positive approach on outcomes of general practice consultations. BMJ. 2001 Oct 20323(7318)908-11.14. Porcerelli JH, Murdoch W, Morris P, Fowler S. The Patient-Doctor relationship questionnaire (PDRQ-9) in primary care A validity study. Journal of Clinical Psychology in Medical Settings. 2014 Aug 921(3)291-6.15. Aloba O, Esan O, Alimi T. Psychometric qualities of the 9 item patient doctor relationship questionnaire in stable Nigerian patients with schizophrenia. Journal of Behavioral Health. 20154(4)112.16. Zenger M, Schaefert R, van der Feltz-Cornelis C, Brhler E, Huser W. Validation of the patient-doctor-relationship questionnaire (PDRQ-9) in a case cross-sectional German Population survey. PLoS ONE. 2014 Mar 179 (3)e91964.17. Van der Feltz-Cornelis CM, Van Oppen P, Van Marwijk HWJ, De Beurs E, Van Dyck R. A patient-doctor relationship questionnaire (PDRQ-9) in primary care exploitation and psychometric evaluation. General infirmary Psychiatry. 2004 Mar26(2)115-20.18. Arafat SMY. Psychometric validation of the Bangla version of the patient-doctor relationship questionnaire. Psychiatry Journal. 201620164.19. Uddin MS, Ahmed MSR, Arafat SMY. Does mind exist in physicians mind? A brief phone survey in Bangladesh. International Journal of Neurorehabilitation. 201603(06)23420. Arafat SMY, Uddin MS, Chowdhury EZ, Huq N, Chouudhury SR, Chowdhury MHR. Demography and Diagnosis of Patients Received Emergency Medical Service from Two Private Psychiatric Hospital in Dhaka City. Int J Neurorehabilitation. 20163(6)240.21. Mergen H, Van der Feltz-Cornelis CM, Karaolu N, Ongel K. Validity of the Turkish patient-doctor relationship questionnaire (PDRQ-Turkish) in comparison with the Europe instrument in a f amily medicine center. Healthmed. 2012 Feb6(5)1763-70.22. J. C. Mingote A, B. Moreno J, R. Rodrguez C, M. Glvez H, P. Ruiz L. Psychometric validation of the Spanish version of the Patient-Doctor Relationship Questionnaire (PDRQ). Actas Esp Psiquiatr. 200937(2)94-100.VM1Please enter the title of the Table 1. Also tables should be below the mentioned text. Copy the text of table 1 before the table. It goes for every table subsequently.