Factors associated with hospital service satisfaction in a sample of Arab subjects with schizophrenia

<p>Abstract</p> <p>Background</p> <p>Assessment of patients' satisfaction with health care services could help to identify the strengths and weaknesses of the system and provide guidance for further development. The study's objectives were to: (i) assess the pattern of satisfaction with hospital care for a sample of people with schizophrenia in Kuwait, using the Verona Service Satisfaction Scale (VSSS-EU); ii) compare the pattern of satisfaction with those of similar studies; and iii) assess the association of VSSS seven domains with a number of variables representing met and unmet needs for care, family caregiver burden, severity of psychopathology, level of psychosocial functioning, socio-demographic characteristics, psychological well-being and objective quality of life.</p> <p>Methods</p> <p>Consecutive outpatients in stable condition and their family caregivers were interviewed with the VSSS-EU and measures of needs for care, caregiver burden, quality of life and psychopathology.</p> <p>Results</p> <p>There were 130 patients (66.1%m, mean age 36.8). While over two-thirds expressed satisfaction with the domains of "overall satisfaction", "professionals' skills", "access", "efficacy", and "relatives' involvement", only about one-third were satisfied with the domains of "information" and "types of intervention". The later two domains were the areas in which European patients had better satisfaction than our patients, while our patients expressed better satisfaction than the Europeans in the domain of "relatives' involvement". In multiple regression analyses, self-esteem, positive and negative affect were the most important correlates of the domains of service satisfaction, while clinical severity, caregiver burden and health unmet needs for care played relatively minor roles.</p> <p>Conclusion</p> <p>The noted differences and similarities with the international data, as well as the predictive power of self-esteem and affective state, support the impression that patients' attitudes towards psychiatric care involve a complex relationship between clinical, personal and socio-cultural characteristics; and that many of the factors that impact on satisfaction with service relate to individual psychological characteristics. The weaknesses in the system, highlighted by the pattern of responses of the participants, indicate possible gaps in the provision of comprehensive psychiatric care in the country and obviate the need for public mental health education and development of services to enhance the quality of care.</p

Direct and Indirect Effects of the Fungicide Carbendazim in Tropical Freshwater Microcosms

Direct and indirect effects of the fungicide carbendazim on ecosystem structure and functioning were studied a parts per thousand currency sign8 weeks after application (nominal concentrations: 0, 3.3, 33, 100, and 1000 mu g/L) to outdoor microcosms in Thailand. Direct effects on macroinvertebrates are discussed in detail in a separate article. The present article presents the effects on other end points and discusses the hypothesized ecologic effect chain. Negative treatment effects on the zooplankton community were only recorded for the highest carbendazim treatment (NOEC(community) = 100 mu g/L). The rotifer Keratella tropica, cladocerans (Moina micrura, Ceriodaphnia cornuta, and Diaphanosoma sp.), and cyclopoid copepods were decreased or even eliminated at this treatment level. The decrease in zooplankton and macroinvertebrate abundances was accompanied by an increase in numbers of several tolerant invertebrates, presumably caused by a release from competition and predation. The death of sensitive invertebrates probably also led to an overall decreased grazing pressure because increased levels of chlorophyll-a and bloom of the floating macrophyte Wolffia sp. were noted. The increase in primary producers is discussed to be the probable cause of changes in physicochemical water conditions, eventually resulting in an anoxic water layer during the last 3 weeks of the experiment. This is likely to have resulted in decreased invertebrate abundances noted in that period. Furthermore, the decreased decomposition of Musa (banana) leaves observed 8 weeks after application is considered to be the indirect effect of a decreased microbial activity resulting from these anoxic water conditions, rather than a direct toxic effect of carbendazim