Measuring patient satisfaction with urinary incontinence treatment

Background: A number of patient satisfaction measures were trialed in a cross-sectional survey of women who had treatment for urinary incontinence (N=187). The psychometric properties of these measures were examined and a short measure for patient satisfaction was developed. Methods: Participants completed a questionnaire comprising items covering incontinence status, treatment type and three generic patient satisfaction questionnaires: the Client Satisfaction Questionnaire (CSQ-18), the Consultation Satisfaction Questionnaire (Consult SQ), and the Patient Satisfaction Index (PSI). Donabedian\u27s model postulates that satisfaction is the patient\u27s judgment on the quality of care. The seven dimensions in this model provide the conceptual framework against which the measures were reviewed. Results: The instruments were examined by their descriptive systems, internal structures and responsiveness. The items from the instruments were examined through iterative Mokken and partial credit IRT analyses against Donabedian\u27s model. Seven items were selected which formed a Short Assessment of Patient Satisfaction (SAPS) scale. Its internal psychometric properties were excellent (α = 0.86) and it provided a patient satisfaction perspective that was most consistent with Donabedian\u27s model. In summary, the internal structures of the instruments suggested that all SAPS items were responsive, but some items on the other measures were insensitive. Also, all measures were shown to be unidimensional. Tests of response bias suggested that this was present in the CSQ-18 and the PSI. Redundancy was observed in the Consult SQ, CSQ-18 and PSI. Conclusions: This study has provided evidence that patient satisfaction can be assessed validly, reliably and sensitively using the much shorter SAPS instrument. This new short measure of patient satisfaction with treatment will be a useful tool for clinicians and evaluators as the population ages

Optimising the residential aged care workforce: leadership & management study

This report is the result of a systematic narrative review of the black and grey literature that aimed to: examine what is known about the issues of leadership and management for the residential aged care workforce; and develop relevant policy options and strategies to improve leadership and management within the social, economical, and political context of Australian residential aged care.The research reported in this paper is a project of the Australian Primary Health Care Research Institute, which is supported by a grant from the Australian Government Department of Health and Ageing under the Primary Health Care Research, Evaluation and Development Strategy

Policy options to improve leadership of middle managers in the Australian residential aged care setting: a narrative synthesis

BACKGROUND The prevalence of both chronic diseases and multi-morbidity increases with longer life spans. As Australia's population ages, the aged care sector is under increasing pressure to ensure that quality aged care is available. Key to responding to this pressure is leadership and management capability within the aged care workforce. A systematic literature review was conducted to inform the policy development necessary for the enhancement of clinical and managerial leadership skills of middle managers within residential aged care. METHODS Using scientific journal databases, hand searching of specialist journals, Google, snowballing and suggestions from experts, 4,484 papers were found. After a seven-tiered culling process, we conducted a detailed review (narrative synthesis) of 153 papers relevant to leadership and management development in aged care, incorporating expert and key stakeholder consultations. RESULTS * Positive staff experiences of a manager's leadership are critical to ensure job satisfaction and workforce retention, the provision of quality care and the well-being of care recipients, and potentially a reduction of associated costs.* The essential attributes of good leadership for aged care middle management are a hands-on accessibility and professional expertise in nurturing respect, recognition and team building, along with effective communication and flexibility. However, successful leadership and management outcomes depend on coherent and good organisational leadership (structural and psychological empowerment).* There is inadequate preparation for middle management leadership roles in the aged care sector and a lack of clear guidelines and key performance indicators to assess leadership and management skills.* Theory development in aged care leadership and management research is limited. A few effective generic clinical leadership programs targeting both clinical and managerial leaders exist. However, little is known regarding how appropriate and effective they are for the aged care sector. CONCLUSIONS There is an urgent need for a national strategy that promotes a common approach to aged care leadership and management development, one that is sector-appropriate and congruent with the philosophy of person-centred care now predominant in the sector. The onus is on aged care industries as a whole and various levels of Government to make a concerted effort to establish relevant regulation, legislation and funding.This study was funded under the Australian Primary Health Care Research Institute (APHCRI) Hub-research grant scheme

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements