Farideh ROSTAMİ, Ghasem ABEDİ, Aliasghar NADİ, Ehsan ABEDİNİ, Kamyar MANSORİ

Hastaların hizmet kalitesinden memnuniyetleri: güvenlik hissinin arabulucu rolü

Amaç: Bu çalışmanın amacı yatan hastaların ve ayaktan hastaların hizmet kalitesinden memnuniyetini hastalarda güvenlik hissi arabulucu rolü ile birlikte saptamaktır.Gereç ve Yöntem: Bu kesitsel çalışmada, tabakalı rastgele örnekleme tekniği 600 kişinin katılımıyla bu çalışmada kullanılmıştır. Hastalar Mazandaran İli'nin iç, ameliyat, kadın ve ayakta ve yatan hastanelerden seçildi. Veri toplamak için iki soru formu kullanılmıştır; biri güvenlik (güvenlik duygusu) ve diğerinin hasta memnuniyetini değerlendirmek için hastanın geçerliliğini ölçmek için kullanılmıştır (SERVQUAL Servis Kalitesi Anketi). Bulgular: Genel olarak, insan boyutunda yaratılan güvenlik duygusunun, hizmet kalitesine etkisi, standart yol katsayısı 0.384'e eşit olarak anlamlıydı ve destek sağlama boyutundan gelen güvenlik duygusu, kalite üzerinde doğrudan bir etki yarattı. 0,524'e eşit standart yol katsayısı ile hizmet desteği. Ayrıca, güvenlik duygusunun yapısal anlamda doğrudan hizmet kalitesi üzerindeki etkisini standartlaştırılmış yol katsayısı 0.168'e göre anlamlı düzeyde etkiledi.Sonuç: Hasta memnuniyeti, hizmet sağlayıcı kuruluşlar için büyük bir sorundur. Başarısızlık analizini gerçekleştirirken ve hizmetlerin kalitesini iyileştirmek için fırsatlar yaratırken etkili adımlar atmak ve hastalara sunulan hizmetlerde kalitesiz boşlukları azaltmak için hedef stratejileri sağlamak gereklidir.

Anahtar Kelimeler:

Hizmet kalitesi, güvenlik duygusu, memnuniyet, yatan hasta, ayakta tedavi

Patients’ satisfaction of service quality: the mediating role of sense of security

Purpose: The aim of this study was to determine the inpatients’ and outpatients’ satisfaction of service quality by the mediating role of senes of security in patients.Materials and Methods: In this cross-sectional study , the stratified random sampling technique was used with the participation of 600 people in this study. The patients were selected from internal, surgery, women, and children outpatient and inpatient units of hospitals of Mazandaran Province. For data collection , two questionnaires were used; one to measure patient sence of security (sense of security) and the other to assess patient satisfaction (SERVQUAL Service Quality Questionnaire).Results: In general, the effect of a sense of security created in the human dimension on the service quality with standardized path coefficient equal to 0.384 was significant, and the sense of security from the dimension of providing support created a direct effect on the quality of service support with standardized path coefficient equal to 0.524 which was significant. Also the direct effect of sense of security in terms of structure on the quality of services by standardized path coefficient equal to 0.168 was significant. Conclusion: The patient satisfaction is a major challenge for the service-provider organizations, it is necessary to take effective steps and provide targeted strategies to reduce gaps in quality in the field of services to patients while conducting failure analysis and creating opportunities to improve the quality of services.

Keywords:

Quality of service, sense of security, satisfaction, inpatient, outpatient,

PDF

___

1. Zafarghandi MR, Rezaei SA, Khalkhali HR. Evaluation of patient satisfaction rate of admission processing in the hospitals of Tehran University of medical sciences. Hakim. 2005;8:31-7.
2. Sohail SM. Service quality in hospitals: more favorable than you might think. Managing Service Quality An International Journal. 2003;13:197-206.
3. Torres EJ, Guo KL. Quality improvement techniques to improve patient satisfaction. Int J Health Care Qual Assur. 2004;17:334-8.
4. Sadati Z. Evaluation of satisfaction of patients to emergency departments of teaching hospitals in Mashhad. Beheshti Univ Med Sci J. 2006;16:30-4.
5. Abedi G, Darvari S H, Nadighara A, Rostami F. The relationship between quality of life and marriage satisfaction in infertile couples using path analysis. J Mazandaran Univ Med Sci. 2014;24:184-93.
6. Abedi G, Ebadattalab I, Rostami F. Analyzing quality gap of nursing services in the selective academic hospitals. Int J Collab Res Intern Med Public Health. 2012;4:1809-15.
7. Campos Andrade C, Lima ML, Pereira CR, Fornara F, Bonaiuto M. Inpatients' and outpatients' satisfaction: the mediating role of perceived quality of physical and social environment. Health Place. 2013;21:122-32.
8. Parasuraman A, Zeithaml V, Berry LL. SERVQUAL: a multiple item scale for measuring consumer perceptions of service quality. J Retailing. 1988;64:12-40.
9. Samorin Z, Hassan T, Gilani N, Hemmati M, Masoudi Gazi M. An explanatory study of the relationship between social capital and feeling of social security (the case of governments' staff in the Golestan province). Security and Social Order Strategic Studies Journal. 2014;7:117-36.
10. Shafipour V, Mohammadi E, Ahmadi F. The perception of cardiac surgery patients on comfortable resources: a qualitative study. Journal of Qualitative Research in Health Sciences. 2012;1:123-
11. Jouybari L, Oskouie F, Ahmadi F. Comfort of hospitalized patients: a missed concept. Iran Journal of Nursing. 2006;19:89-101.
12. Funk LM, Allan DE, Stajduhar KI. Palliative family caregivers’ accounts of health care experiences: the importance of security. Palliat Support Care. 2009;7:435-47.
13. Milberg A, Wahlberg R, Jakobsson M, Olsson EC, Olsson M, Friedrichsen M.. What is a ‘‘secure base’’ when death is approaching? A study applying attachment theory to adult patients’ and family members’ experiences of palliative home care. Psychooncology. 2012;21:886-95.
14. World Health Organization; WHO reports 10 facts on patient safety and surgery safety. Geneva, WHO, 2010
15. Abedi G, Azimehr L, Rostami F, Mohammadi S. Applying a model of patient's right in the state hospital, Sari, Iran. Int J Collab Res Intern Med Public Health. 2012;4:103-10.
16. Yavari F. Patient’s safety and the human rights system. Medical Law. 2011;5:117-131.
17. Otani K, Kurts RS, Buroughs TE, Waterman B. Reconsidering models of patients’ satisfaction and behavioral intentions. Health Care Manage Rev. 2003;28:7-14.
18. Otani K, Kurz RS. The impact of nursing care and other healthcare attributes on hospitalized patient satisfactionand behavioral intentions. J Healthc Manag. 2004;49:181-96.
19. Quintana JM, González N, Bilbao A, Aizpuru F, Escobar A, Esteban C, Thompson A et al. Predictors of patient satisfaction with hospital health care. BMC Health Services Res. 2006;6:102.
20. Jha AK, Orav EJ, Zheng J, Epstein AM. Patients' perception of hospital care in the United States. N Engl J Med. 2008;359:1921-31.
21. Boundreaux ED, Mandry CV, Wood K. Patient satisfaction data as a quality indicator: a tale of twoemergency departments. Acad Emerg Med. 2003;10:261-8.
22. Chang CW, Tseng TH, Woodside AG. Configural algorithms of patient satisfaction, participation in diagnostics, and treatment decisions' influences on hospital loyalty. Journal of Services Marketing. 2013;27:91-103.
23. Godwin UJ, Bagchi K K, Kirs PJ. Using Servqual to assess the quality of e-learning experience. Comput Human Behav. 2011;27:1272-83.
24. Tabibi J, Kakhani M, Gohari M, Shahri S. The relationship between services quality and patient's loyalty in Tehran public and private hospitals:2009. Hospital Journal. 2010;8:35-42.
25. Kupfer JM, Bond EU. Patient satisfaction and patient-centered care: necessary but not equal. JAMA. 2012;308:139-40.
26. Kurpas D, Steciwko A. Patient satisfaction as the main indicator of primary care quality. Przegl Lek. 2005;62:1546-51.
27. Nadi A, Abedi Gh, Abedi E, Rostami F. Design and validation of a sense of security questionnaire to patients in hospitals. Journal of Mazandaran University of Medical Sciences. 2018; [In press].
28. Kenny DA, Judd CM. Estimating the nonlinear and interactive effects of latent variables. Psychol Bull. 1984;96:201–10.
29. Li M, Lowrie DB, Huang CY, Lu XC, Zhu YC, Wu XH et al. Evaluating patients' perception of service quality at hospitals in nine Chinese cities by use of the Servqual scale. Asian Pac J Trop Biomed 2015;5:497–504.
30. Jabnoun N, Chaker M. Comparing the quality of private and public hospitals. Managing Service Quality 2003;13:290-9.
31. Khalid J., Shahid A., L. Evaluation of outpatient service quality in Eastern Saudi Arabia Patient’s expectations and perceptions. Saudi Med J 2016;37:420-428.
32. Aghamolaei T, Zare SH, Poudat A, Kebriyaei A. Customer’s perception and expectation of primary healthcareservices quality in health centers of Bandar Abbas. Hormozgan University of Medical Sciences Journal 2007;3:173-179.
33. Zarei A, Arab M, Rahimi Froushani A, Rashidian A, Ghazi Tabatabaei M. Service quality of private hospitals: The Iranian patients’ perspective BMC Health Serv Res. 2012;12:31.
34. Anbari Z, Tabaraie Y. Measurement of Quality of Hospital Services via SERVQUAL Model. Bulletin of Environment, Pharmacology and Life Sciences. 2013;3:51-56.
35. Yousapronpaiboon K, Johnson WC. Out-patient service quality perceptions in private Thai hospitals. International Journal of Business and Social Science. 2013;4:57-66.
36. Molazem Z, Ahmadi F, Mohammadi E, Bolandparvaz SH. Nursing presence: essential element of caring of patients'perceptions. Iran J Med Ethics Hist Med. 2010;3:44-54.
37. Jouybari L, Haghdoost Oskouee S, Ahmadi F. Comforting nurse: patients’ experiences and perceptions. Razi Journal of Medical Sciences. 2005;12:59-68.
38. Tobaee S, Dehbozorgi G. Patients’ expectations from internists, psychiatrists and surgeons. Medical Journal of Hormozgan University 2004;8:41-7.
39. Baldursdottir G, Jonsdottir H. The importance of nurse caring behaviors as perceived by patients receiving care at an emergency department. Heart Lung. 2002;31:67-75.
40. Hawley MP. Nurse comforting strategies: perceptions of emergency department patients. Clin Nurs Res. 2000;9:441-59.
41. Harris P, McBride G, Ross C, Curtis L. A place to heal: environmental sources of satisfaction among hospital patients. J Appl Soc Psychol. 2002;32:1276–99.
42. Madani G, Farzan A, Rabiei M. Patients’ satisfaction from medical and nursing services. Journal of Nursing & Midwifery Research School of Isfahan. 2004;(24):15.
43. Swan J, Richardson L, Hutton J. Do appealing hospital rooms increase patient evaluations of physicians, nurses, and hospital services? Health Care Manage Rev. 2003;28:254–64.
44. Hagerman I, Rasmanis G, Blomkvist V, Ulrich RS, Eriksen CA, Theorell T. Influence of coronary intensive care acoustics on the quality of care and physiological states of patients. Int J Cardiol. 2005;98:267–70.
45. Tutton E, Seers K. Comfort on a ward for older people. J Adv Nurs. 2004;46:380-9.
46. Hosseinian M. A Survey on nurses’ attitude in respecting clients’ rights in different wards of Hamedan Medical Sciences University. Nursing Midwifery Research Journal. 2005;3:26.
47. Gotlieb JB. Understanding the effects of nurses on theprocess by which patients develop hospital satisfaction. Holist Nurs Pract. 2002;17:49-60.
48. Igarashi A, Miyashita M, Morita T, et al. A scale for measuring feelings of support and security regarding cancer care in a region of Japan: a potential new endpoint of cancer care. J Pain Symptom Manage. 2012;43:218-25.
49. McKenzie H, Boughton M, Hayes L, Forsyth S, Davies M, Underwood E et al. A sense of security for cancer patients at home: the role of community nurses. Health Soc Care Community. 2007;15:352-9.
50. Milberg A, Friedrichsen M, Jakobsson M, Nilsson EC, Niskala B, Olsson M et al. Patients' sense of security during palliative care-what are the influencing factors? J Pain Symptom Manage. 2014;48:45-55.
51. Demir C, Celik Y. Determinants of patient satisfaction in a military teaching hospital. J Healthc Qual. 2002;24:30-4.
52. Saydi M. Satisfaction in inpatient wards-surgical medical and nursing services. J Nurs. 2004;7:61-5.
53. Moosazadeh M, Nekoei-moghadam M, Amiresmaili M. Determining the level of hospitalized patients satisfaction of hospitals: a systematic review and meta-analysis. Hospital Journal. 2013;12:77-87.