Measuring Patient Satisfaction With Diabetes Treatment in Pakistan
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Transcript of Measuring Patient Satisfaction With Diabetes Treatment in Pakistan
1
Contents
ABSTRACT .............................................................................................................. 2
1. INTRODUCTION ............................................................................................... 3
2. METHODOLOGY ............................................................................................... 5
3. RESULTS ........................................................................................................... 5
4. SATISFACTION.................................................................................................. 6
5. UNDERSTANDING ............................................................................................ 8
6. CONVENIENT ................................................................................................. 11
7. FLEXIBILITY .................................................................................................... 13
8. RECOMMEND ................................................................................................ 16
9. CONTINUE ..................................................................................................... 18
10. ENVIRONMENT .............................................................................................. 21
11. FINDINGS ....................................................................................................... 24
12. CONCLUSION ................................................................................................. 25
13. REFERENCES .................................................................................................. 27
2
ABSTRACT
Diabetes is a very serious and complex disease whose patients require very individual
treatment by doctors and nurses basing upon their diabetes type and other medical conditions.
The amount of commitment and support provided by doctors and nurses will increase patient
satisfaction in them and their treatment. Healthcare providers see patient satisfaction surveys
as a tool to measure the service and care being provided by them. In this way, healthcare
providers identify their strengths where they have given satisfactory services and similarly areas
of concern where they need improvements to create a more responsive patient-centered
service. In Pakistan, due to changing way of life and increase in poverty, diabetes prevalence is
increasing and more diabetes patients are being treated in hospitals/clinics. Healthcare
providers in Pakistan need these satisfaction surveys to measure their quality of service and
identify areas for improvement. This research has focused on finding those areas where
diabetes patient feel satisfied with the treatment and areas where improvement is needed. For
this purposes, a questionnaire based satisfaction survey with diabetes treatment was carried
out in major hospitals of Rawalpindi, Abbottabad and Peshawar. A total of 105 responses were
received and analysis of results was then carried out by using StatPro. In this research study, it
was observed to involve satisfaction with treatment, understanding of treatment and diabetes,
convenience, flexibility, recommendation of treatment to others with similar condition,
continuance of treatment and environment of hospital/clinic as variables which will measure
the patient satisfaction with the diabetes treatment. The objective was to measure patient
satisfaction with the diabetes treatment they are receiving and find variables which patient
consider more critical for their treatment. Healthcare providers will also benefit a lot from this
research as it will tell them about areas of concern which needs further improvement as patient
views about diabetes treatment will be put for analysis.
3
1. INTRODUCTION
Healthcare providers can achieve quality when services provided by them increases patients
satisfaction with the treatment and resultantly improves their health outcomes. According to
institute of medicine, healthcare providers can achieve this quality in service by giving
importance to patient safety, patient centeredness, efficiency and effectiveness of treatment,
equity and timeliness [1]. As prevalence of diseases like diabetes is growing at an alarming rate,
it has become essential for healthcare providers to know about patient feedback on the
treatment, medication and self care education so that further improvements can be made in
the services. Diabetes is a very serious and complex disease, and its treatment is very
individualized depending upon the type of diabetes and other medical conditions existing in the
patient [2]. Pakistan with a population of over 160 million has 12% people above the age of 25
suffering from this disease and it is continuously increasing. Lifestyle changes, economic and
socio-cultural situation have resulted in 37% of men and 79% of women with diabetes as obese
[3]. Cost of diabetes treatment is also very high which is not affordable by all. In order to find
the cost of treatment, a questionnaire based study was conducted in outpatient clinics at
Karachi, Pakistan and data was collected from 345 diabetes patient. It was found out that
average cost for treatment per person with diabetes is around Pakistani rupees 11,580 (US$
197) and around 18% of family income is being spent on diabetes care [4]. So it has become
very necessary for healthcare providers to run programs which provide better and effective
treatment at low cost with the feedback from patient satisfaction surveys.
Patient feedback is very important as it helps to understand between healthcare provider
perception and patient perception of diabetes. The feedback reduces the differences and helps
not only provider but also the patient as well [5]. Provider set action plan for improvement in
areas of concern and create more responsive patient centered service whereas patient in
return gets better healthcare services. Key patient satisfaction components are defined as
interpersonal manners of providers with patients, competency of providers in giving better
treatment and medication, convenience of treatment, continuity of care, environment,
availability, cost of care and health outcomes [6]. A diabetes measurement and evaluation tool
for measuring diabetes disease management programs was developed for assessing not only
4
patient satisfaction with health outcomes but also system of healthcare services at
Philadelphia, USA. The questionnaire consisted of variables like meetings with staff, their
behavior, hospital/clinic environment, understanding of general and severe complications, diet,
exercise and commitment to the program [7]. A self audit over care provided by a diabetic clinic
in Nigeria on 118 patients was carried out and it was found out that quality of care being
provided is low and some key areas like referrals and treatment needs further improvement
[8]. A similar study was carried out in Turkey to find out health related quality of life factors
which can be used by healthcare providers for better management of diabetes. 376 patients
with type II diabetes participated in that study and gave importance to demographics and
medical history [9]. A disease state management program for type II diabetes was delivered by
community pharmacists in Australia and 114 patients reported satisfaction with the services
being provided by pharmacists’, satisfaction with self care and were satisfied with
understanding of their own condition with diabetes [10]. A short version of quality from the
patient’s perspective (QPP) questionnaire was used in primary healthcare centers of Sweden to
assess patient satisfaction with continuity of treatment with the same provider and 10% patient
refused to continue treatment with the same healthcare center [11]. A more specific tool for
measuring diabetes patient satisfaction is diabetes treatment satisfaction questionnaire (DTSQ)
and it consists of six variables for finding patient satisfaction with diabetes treatment (satisfied,
understanding, convenient, flexible, recommend and continue) and two variables for finding
perceived hyperglycemia and hypoglycemia [12]. It works for both type I and type II diabetes
patients and, is a good and effective tool for measuring patient satisfaction with the diabetes
treatment. In present study, it was observed to involve satisfaction with treatment,
understanding of treatment and diabetes, convenience, flexibility, recommendation of
treatment to others with similar condition, continuance of treatment and environment of
hospital/clinic as variables which will measure the patient satisfaction with the diabetes
treatment. While a lot of research has been carried out in other countries about finding patient
feedback with diabetes treatment, there is very less information available here in Pakistan on
getting patient responses on diabetes treatment as there are very limited special diabetes
centers to look after care and treatment of diabetes. Patient with diabetes generally go to
5
hospitals/clinics to see doctors/nurses who are also treating and providing care to patients with
other medical conditions. Present research was therefore focused on finding patient
satisfaction with diabetes treatment from hospitals at Rawalpindi, Abbottabad and Peshawar.
The objective was to measure patient satisfaction with the diabetes treatment they are
receiving and find variables which patient consider more critical for their treatment. Healthcare
providers will also benefit a lot from this research as it will tell them about areas of concern
which needs further improvement as patient views about diabetes treatment will be put for
analysis.
2. METHODOLOGY
A patient satisfaction survey was carried out to find satisfaction with diabetes treatment by
using six variables from DTSQ (satisfied, understanding, convenient, flexible, recommend and
continue) and one variable from QPP (environment) [11, 12]. A total of 10 questions on a seven
point likert scale, with 1 being poor and 7 being excellent, were then used basing upon these
seven variables to measure patient satisfaction and analysis was carried out by using StatPro. A
total of 140 questionnaires were sent out to diabetes patient undergoing treatment in hospitals
at Rawalpindi, Abbottabad and Peshawar. Out of which 105 good responses came back and
data from these questionnaire was then analyzed by StatPro. Strength and weaknesses of
variables were then found to see which aspect of treatment is more critical to the patient
satisfaction and where healthcare providers can work for more improvement.
3. RESULTS
Demographics of diabetes patients responding to questionnaire was found to be as shown in
table 1:
6
Gender (n [%])
Male 56 (53.3)
Female 49 (46.7)
Age (n [%])
<20 3 (2.9)
20-30 10 (9.5)
31-40 12 (11.4)
41-50 41 (39.1)
50+ 39 (37.1)
Diabetes Type (n [%])
Type I 24 (22.9)
Type II 81 (77.1) Table 1: Demographics of patients responding to questionnaire (n = 105)
Due to changing lifestyle and socio-cultural situation, 76% of the respondents above the age of
40 are suffering from type II diabetes. They need good responsive treatment which is safe,
caring, efficient and effective provided by the doctors and nurses. Result for each variable in
the questionnaire is also shown in table 2:
Variable n Min Max Mean SD
Satisfied 105 1 7 4.66 1.350
Understanding 105 2 7 4.71 1.278
Convenient 105 1 7 4.49 1.345
Flexible 105 1 7 4.59 1.472
Recommend 105 1 7 4.70 1.611
Continue 105 1 7 4.69 1.654
Environment 105 1 7 5.54 1.330 Table 2: Result for each variable in the questionnaire
4. SATISFACTION
Diabetes treatment is given individually to each patient in two ways, which are medical
treatment by the healthcare providers and self care education to patient. Medical treatment
consist of right diagnosis by the doctors, treating patient in a positive way, giving sincere
answers, showing respect and care, supporting patient emotionally to overcome the disease.
Self care education is a very important part of the diabetes treatment as goals for lifestyle
changes are set mutually between doctor and patient, and periodically those goals are
reviewed. Diet, exercise, quitting smoke and alcohol, and self monitored blood glucose are part
of the life style changes. Self care also includes periodic medical tests after diagnosis which are
7
carried out by the patient at hospital under the supervision of doctors or nurses and home
administered by themselves or by their family. Two questions were asked for this variable
regarding satisfaction with treatment and, care and support being provided by the doctors and
nurses. Data collected for satisfaction with diabetes treatment from patients is shown in figure
1:
Figure 1: satisfaction of patients with diabetes treatment
Following inferences could be drawn from the above figure:
a. Right diagnosis, good treatment and commitment from doctors and nurses have
led to higher satisfaction as 59% patients have rated higher satisfaction with
treatment being provided to them in hospitals. Doctors spent time with the
patients in telling them about their condition, blood sugar control, supporting
them emotionally and telling them about important aspects of self care.
12
15
2524
25
13
0
5
10
15
20
25
30
1 (Poor) 2 3 4 5 6 7 (Excellent)
Category
Histogram for Satisfaction
8
b. Patient also felt greater satisfaction by the respect and care shown by healthcare
providers thus making them feel that doctors and nurses are equally involve with
them in the treatment process and understand their condition.
c. On the other hand, doctors and nurses have to be more responsive to patient
needs and their feelings as 17% respondents rated low satisfaction with
treatment. Doctors were unable to give due time to these patients and didn’t
diagnose them properly which resulted in unsatisfactory treatment.
5. UNDERSTANDING
Patient satisfaction increases when doctor is able to understand his/her situation and
condition. Basing upon this understanding, the doctor is then able to diagnose rightly and start
the treatment process. As doctors have to treat diabetes patient individually therefore not only
they have to understand patient condition but also make patient understand about the
diabetes type, its treatment, goals for lifestyle changes, self care and tests to be monitored
both by the patient and doctor. Two questions were asked for this variable regarding
understanding by doctor of patient situation and patient understanding of his/her diabetes.
Data collected for understanding of diabetes treatment from patients is shown in figure 2:
9
Figure 2: Understanding of patients with diabetes treatment
Following inferences could be drawn from the above figure:
a. Doctors understood the patient situation rightly and were than able to provide
the right treatment and made patient understand as well about diabetes and
information about medication and self care as 71% patients have rated higher
satisfaction with understanding of diabetes.
b. As part of treatment and self care information provided by doctors and nurses,
patients were made aware of the different tests they have to do regularly like
blood glucose tests, blood pressure, checking of cholesterol, kidney function
tests, foot check, eye check and measurement of weight.
c. They were also told about how to maintain their diet plans and to do regular
exercises to control their diabetes which resulted in higher patient satisfaction in
their doctors and nurses, and treatment being provided by them.
03
16
11
3431
10
0
5
10
15
20
25
30
35
40
1 (Poor) 2 3 4 5 6 7 (Excellent)
Category
Histogram for Understanding
10
d. On the contrary, 18% patients were unsatisfied with the understanding of their
treatment as doctors failed to convey them about the purpose of medical tests
and their results. Also they were given very limited information about the
medication and their side effects.
Correlation between satisfaction with treatment and understanding of treatment was also
plotted to see relation between these two variables as doctors and nurses can only provide
better treatment and care when they understands the situation and condition of the patient.
Better understanding of condition leads to right diagnosis, better medication and self care
awareness for the patient. Correlation plotted between these two variables is shown below in
figure 3:
Figure 3: Correlation between satisfaction with treatment and understanding
A very strong correlation of 0.713 exists between satisfaction with treatment and
understanding showing that patients are satisfied with diabetes treatment being provided to
1
2
3
4
5
6
7
8
1 2 3 4 5 6 7
Sati
sfac
tio
n
Understanding
Satisfaction
Poly. (Satisfaction)
Correlation = 0.713
11
them at hospitals. They understood their condition, implications and purpose of the
medications. Similarly there are 18% patients, as seen from the above figure who are away
from the cluster, unsatisfied with their treatment which is due to poor treatment being
provided to them and resulting in low understanding of their diabetic condition.
6. CONVENIENT
Convenient is related to availability and affordability of treatment to the patient with ease.
Patient satisfaction increases when hospital/clinic is near to them, treatment is provided within
acceptable waiting time, is affordable and if necessary, then able to use the treatment easily by
them or with the help of their family members like using injections. Two questions were asked
for this variable regarding receiving of treatment in acceptable waiting time and convenience of
treatment to patient. Data collected for convenience of diabetes treatment to patients is shown
in figure 4:
Figure 4: Convenience of diabetes treatment to patient
1
7
15 14
34
29
5
0
5
10
15
20
25
30
35
40
1 (Poor) 2 3 4 5 6 7 (Excellent)
Category
Histogram for Convenient
12
Following inferences could be drawn from the above figure:
a. Around 65% diabetes patient have shown higher satisfaction with convenience
of treatment as they have received the treatment in acceptable waiting time and
found medication easy to use at home.
b. Patients got appointment with their doctors easily and subsequently received
the diagnosis, test results and medications within 2-3 days.
c. Patients were also educated on how to use the treatment by themselves like
taking injections at home as part of self care. Their families were also made part
of this learning process so that they may also help patients in the treatment.
d. As diabetes treatment is becoming costly, this was also evident from the results
as its treatment was not very affordable to 22% patients. They also did not
receive the treatment in due time which also added to their unsatisfaction.
Correlation between satisfaction with treatment and convenience of treatment was also
plotted to see relation between these two variables as patient feel satisfaction with the
treatment when they can contact doctors and nurses with ease and treatment is provided
within acceptable cost. Better understanding of diabetes medication use by the patient at
home also leads to satisfaction. Correlation plotted between these two variables is shown
below in figure 5:
13
Figure 5: Correlation between satisfaction with treatment and convenience
A strong correlation of 0.672 exists between satisfaction with treatment and convenience
showing that patients are satisfied with diabetes treatment being provided to them at
hospitals. They had received treatment within acceptable waiting time and have understood
how to use the medication at home as part of self care awareness provided by the doctors and
nurses. Similarly there are 22% patients, as seen from the above figure who are away from the
cluster, unsatisfied with their treatment which is due to high cost of the treatment and longer
waiting time for appointment, diagnosis and test results.
7. FLEXIBILITY
Flexibility means how treatment can be changed according to patient’s requirement. Choosing
of time for appointment, choosing doctor, changing dosage and discussing alternative
treatment is very necessary for patient satisfaction. This gives patients great flexibility to
choose their treatment by themselves with the support and care from healthcare providers.
1
2
3
4
5
6
7
8
1 2 3 4 5 6 7 8
Sati
sfac
tio
n
Convenient
Satisfaction
Poly. (Satisfaction)
Correlation = 0.672
14
One question was asked for this variable regarding flexibility of diabetes treatment to patient.
Data collected for flexibility of diabetes treatment to patients is shown in figure 6:
Figure 6: Flexibility of diabetes treatment to patient
Following inferences could be drawn from the above figure:
a. With the help from doctors and nurse, diabetes patients were able to choose
their treatment alternatives and administer their dosages easily thus causing
higher satisfaction among 57% of the respondents.
b. They were able to make healthy diet plans and schedule for regular exercises
with the help from healthcare providers. In this way their quality of life was
maintained and resulted in satisfaction among them.
2
8
17 18
25
29
6
0
5
10
15
20
25
30
35
1 (Poor) 2 3 4 5 6 7 (Excellent)
Category
Histogram for Flexible Q_7
15
c. On the contrary, 26% diabetes patients complained of rigid treatment with no
options for alternative medication. This resulted in lower satisfaction on their
treatment and less confidence on their doctors and nurses.
Correlation between satisfaction with treatment and flexibility of treatment was also plotted to
see relation between these two variables as patient feel satisfaction with the treatment when
they can choose their appointment timings with doctors, choose alternative treatment and able
to change their medications as per their needs. Correlation plotted between these two
variables is shown below in figure 7:
Figure 7: Correlation between satisfaction with treatment and flexibility
A correlation of 0.487 exists between satisfaction with treatment and flexibility showing that
patients are satisfied with diabetes treatment being provided to them at hospitals. Patients
were able to choose alternative treatments, choose their doctors and change their medication
as their requirements changed. Similarly there are 26% patients, as seen from the above figure
1
2
3
4
5
6
7
8
1 2 3 4 5 6 7 8
Sati
sfac
tio
n
Flexible Q_7
Satisfaction
Poly. (Satisfaction)
Correlation = 0.487
16
who are away from the cluster, unsatisfied with their treatment which is due to rigid diabetes
treatment program being given to them at hospitals resulting in low satisfaction.
8. RECOMMEND
Patient satisfaction is also measured once patients recommend their treatment plans, doctors,
nurses, hospital to their relatives, friends and colleagues experiencing similar kind of situation
and condition which they themselves are going through. One question was asked for this
variable regarding recommendation of diabetes treatment by patient to someone else
experiencing similar kind of situation. Data collected for recommendation of diabetes
treatment by patients is shown in figure 8:
Figure 8: Recommendation of diabetes treatment by patient
2
13 1311
20
39
7
0
5
10
15
20
25
30
35
40
45
1 (Poor) 2 3 4 5 6 7 (Excellent)
Category
Histogram for Recommend Q_8
17
Following inferences could be drawn from the above figure:
a. With right diagnosis, positive treatment plans, easy to use medications and
caring attitude by the healthcare providers, 63% patients have rated their
treatment with greater satisfaction and recommend it to someone else with
their kind of situation and condition.
b. Doctors and nurses have made patients understand about their situations and
self care which they have to follow. They have also told them about goals for
changing lifestyle, diet and regular exercise.
c. Patients were satisfied by the total commitment from the healthcare providers
and are willing to recommend this to others facing similar diabetes types like
themselves.
d. On the contrary, 26% patients do not feel recommending their treatment to
others due to high cost of treatment and rigid treatment plans. They were also
not able to understand their condition fully as doctors have not told them about
the purpose of medication and self care awareness.
Correlation between satisfaction with treatment and recommendation of treatment was also
plotted to see relation between these two variables as patient feel satisfaction with the
treatment when they can recommend their treatment to others. Correlation plotted between
these two variables is shown below in figure 9:
18
Figure 9: Correlation between satisfaction with treatment and recommend
A correlation of 0.532 exists between satisfaction with treatment and recommend showing that
patients are satisfied with diabetes treatment being provided to them at hospitals. Patients feel
satisfied with the diabetes treatment, diagnosis, medication, acceptable waiting time,
education being provided to them about self care and flexibility of treatment. Therefore they
feel confident in recommending their hospital and its staff to other people with similar
condition. Similarly there are 26% patients, as seen from the above figure that are away from
the cluster, unsatisfied with their treatment which is due to high cost of treatment, rigid
diabetes treatment program and less education about self care being given to them at hospitals
resulting in low satisfaction.
9. CONTINUE
Once patient are satisfied with their doctors and nurses, treatment plans, medication and self
care plans, cost and flexibility of treatment, they feel happy to continue with their treatment.
1
2
3
4
5
6
7
8
1 2 3 4 5 6 7 8
Sati
sfac
tio
n
Recommend Q_8
Satisfaction
Poly. (Satisfaction)
Correlation = 0.532
19
One question was asked for this variable regarding continuation of diabetes treatment with the
same hospital and medical staff. Data collected for continuation of diabetes treatment by
patients is shown in figure 10:
Figure 10: Continuation of diabetes treatment by the patient
Following inferences could be drawn from the above figure:
a. Patients felt happy to continue with their treatment plans currently being run by
their healthcare providers as 63% patients wanted to continue with their
treatment and have rated it with higher satisfaction.
b. They were happy with the hospital environment, doctors/nurses behavior,
treatment plans, medication and self care programs being run by healthcare
providers.
3
1213
11
2628
12
0
5
10
15
20
25
30
1 (Poor) 2 3 4 5 6 7 (Excellent)
Category
Histogram for Continue Q_9
20
c. They also appreciated the choosing of appointments, affordability of treatment,
choosing alternative treatment plans, medications being provided to them and
modern equipment available to them for medical tests.
d. On the contrary, 26% patients do not feel to continue with their treatment due
to long waiting times and delayed information on test results. They were also not
able to understand their condition fully as doctors have not told them about the
purpose of medication and self care awareness.
Correlation between satisfaction with treatment and continuation of treatment was also
plotted to see relation between these two variables as patient feel satisfaction with the
treatment when they are able to continue their treatment plans being provided by the hospital
and its staff. Correlation plotted between these two variables is shown below in figure 11:
Figure 11: Correlation between satisfaction with treatment and continue
1
2
3
4
5
6
7
8
1 2 3 4 5 6 7 8
Sati
sfac
tio
n
Continue Q_9
Satisfaction
Poly. (Satisfaction)
Correlation = 0.666
21
A strong correlation of 0.666 exists between satisfaction with treatment and continuation
showing that patients are satisfied with diabetes treatment being provided to them at
hospitals. Patients feel satisfied with the diabetes treatment, diagnosis, medication, acceptable
waiting time, education being provided to them about self care and flexibility of treatment.
Therefore they feel confident in continuing with the treatment provided to them by their
hospital and its staff. Similarly there are 26% patients, as seen from the above figure that are
away from the cluster, unsatisfied with their treatment which is due to long waiting times,
delayed information on test result and less education about self care being given to them at
hospitals resulting in low satisfaction.
10. ENVIRONMENT
Environment plays a major role in providing satisfaction to patient. Before seeing a doctor,
patient sees environment of the hospital/clinic and makes opinion about the treatment and
attitude he/she is about to receive from the doctors/nurses. One question was asked for this
variable regarding how patient find the environment of hospital. Data collected for
environment of hospital is shown in figure 12:
22
Figure 12: Environment of hospital
Following inferences could be drawn from the above figure:
a. Patients were found to be very much satisfied with the environment and
atmosphere of the hospitals as 84% patients have rated environment with higher
satisfaction.
b. Patients were attracted to the cleanliness, comfort and helping atmosphere of
the hospitals and felt satisfied about the treatment they have received.
c. They also felt satisfied in talking to doctors and nurses in private about their
condition and knew that their privacy will be valued.
d. Similarly 10% patients were not satisfied with the environment of the hospitals
they visited which was due to untidiness, rude attitude of nurses and patient
rush in the hospitals.
2 26 7
20
46
22
0
5
10
15
20
25
30
35
40
45
50
1 (Poor) 2 3 4 5 6 7 (Excellent)
Category
Histogram for Environment Q_10
23
Correlation between satisfaction with treatment and environment of hospital was also plotted
to see relation between these two variables as patient feel satisfaction with the treatment
when they find good environment of the hospital. Correlation plotted between these two
variables is shown below in figure 13:
Figure 13: Correlation between satisfaction with treatment and environment of hospital
A correlation of 0.501 exists between satisfaction with treatment and environment of the
hospitals showing that patients are satisfied with diabetes treatment being provided to them at
hospitals. Patients feel satisfied with the atmosphere of the hospital, helping attitude of nurses,
value of privacy about their treatment provided to them and cleanliness at the hospital.
Similarly there are 10% patients, as seen from the above figure that are away from the cluster,
unsatisfied with their treatment which is due to untidiness, rude attitude of nurses and patient
rush in the hospitals resulting in low satisfaction.
1
2
3
4
5
6
7
8
1 2 3 4 5 6 7 8
Sati
sfac
tio
n
Environment Q_10
Satisfaction
Poly. (Satisfaction)
Correlation = 0.501
24
11. FINDINGS
Present research lead to following findings:
a. Right diagnosis, good treatment and commitment from doctors and nurses have
led to higher satisfaction among patients. Patient also felt greater satisfaction by
the respect and care shown by healthcare providers thus making them feel that
doctors and nurses are equally involve with them in the treatment process and
understand their condition.
b. Doctors understood the patient situation rightly and were than able to provide
the right treatment and made patient understand as well about diabetes and
information about medication and importance of self care.
c. Diabetes patient have shown satisfaction with convenience of treatment as they
have received the treatment in acceptable waiting time and found medication
easy to use at home.
d. High cost of diabetes treatment and rigid treatment plans was dissatisfaction
among 22% patients as they find it not very affordable.
e. With the help from doctors and nurse, diabetes patients were able to choose
their treatment alternatives and administer their dosages easily showing
flexibility of treatment. They were able to make healthy diet plans and schedule
for regular exercises with the help from healthcare providers. In this way their
quality of life was maintained and resulted in satisfaction among them.
f. Patients were satisfied by the total commitment from the healthcare providers
and are willing to recommend their treatment to others facing similar diabetes
types like themselves.
g. Patients felt happy to continue with their treatment plans currently being run by
their healthcare providers. They were happy with the hospital environment,
25
doctors/nurses behavior, treatment plans, medication and self care programs
being run by healthcare providers.
h. Patients were found to be very much satisfied with the environment and
atmosphere of the hospitals as 84% patients have rated environment with higher
satisfaction.
i. Patients were attracted to the cleanliness, comfort and helping atmosphere of
the hospitals and felt satisfied about the treatment they have received. They also
felt satisfied in talking to doctors and nurses in private about their condition and
knew that their privacy will be valued.
Above findings led to certain conclusions which will help healthcare providers to see areas
where they are providing high satisfaction treatment and care to patients, and some areas of
concern where they need more improvements to provide quality care to patients.
12. CONCLUSION
Diabetes patients need very high quality care as diabetes brings number of other medical
complications which not only affects them and their way of living but most importantly to their
family members. After diagnose and medical treatment, a lot of self care education has to be
given by doctors and nurses to diabetes patients. Due to very limited availability of special
diabetes treatment centre, as present in Canada, England and Ireland where courses and
classes are run for the education of patient about diabetes, doctors and nurses here in Pakistan
have to educate more to patients in order to make them understand about self care and,
regular checkups and tests. Similarly doctors have to give more options to patient in terms of
selecting for alternative treatment plans and choosing appointments. They should also give
flexibility to patients in terms of changing their dosages. Diabetes treatment is becoming costly
and it is becoming difficult for healthcare providers alone to make it affordable for all. For this
government should also intervene in making healthcare facilities accessible for all. By providing
positive treatment, right diagnosis, easy to use medication, interpretation of test results,
getting understanding of patients in the use of medication and their condition, care and
26
emotional support, and better environment at hospitals will make patients continue with their
treatment and will also make them to recommend their treatment to someone else with similar
diabetic condition resultantly showing satisfaction over their treatment.
27
13. REFERENCES
[1] Institute of Medicine, ‘Crossing the Quality Chasm: A New Healthcare System for
the 21st Century’, 2001.
[2] eMedicineHealth Home Page. Available at:
http://www.emedicinehealth.com/diabetes/article_em.htm.
[3] Fatema Jawad, ‘Diabetes in Pakistan’. Diabetes Voice, Vol 48, Issue 2, 12-14, July
2003.
[4] Liaquat A Khowaja, Ali K Khuwaja, Peter Cosgrove, ‘Cost of Diabetes Care in Out-
Patient Clinics of Karachi, Pakistan’. BioMed Central Health Services Research,
7:189, 2007.
[5] James T. Fitzgerald, R. Brent Stansfield, Tricia Tang, Mary Oh, Alice Frohna, Betty
Armbruster, Larry Gruppen, Robert Anderson, ‘Patient and Provider Perceptions
of Diabetes: Measuring and Evaluating Differences’. Patient Education and
Counseling 70 (2008), Elsevier. 118-125, 2007.
[6] John Sitzia, Neil Wood, ‘Patient Satisfaction: A Review of Issues and Concepts’.
Social Science Medicine, Elsevier. Vol 45, No 12, pp 1829-1843, 1997.
[7] Lisa E. Paddock, Jon Veloski, Mary Lou Chatterton, Felicia O. Gevirtz, David B.
Nash, ‘Development and Validation of a Questionnaire to Evaluate Patient
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