|dc.contributor.author||Chow, Maria Yui Kwan||-|
|dc.description||Master of Philosophy (Medicine)||en|
|dc.description.abstract||Health care evaluation serves the purpose of monitoring the quality of health care
provided by Health Care Providers (HCP), so that health care services can be provided
most effectively and efficiently. Patient satisfaction studies are widely used to assess the
quality of outpatient care. A client satisfaction study was conducted at an HIV health care
facility in Sydney, Australia during 2007-2008. There were three objectives: 1.) To
validate a questionnaire for future determination of client satisfaction in HIV health care
facilities. 2.) To identify the levels of satisfaction of clients, and investigate any
dissatisfaction and unmet needs towards HIV health care. 3.) To provide
recommendations for improving client satisfaction levels in HIV health care.
This research used a mixed method approach and consisted of two phases. The first
phase was a quantitative survey conducted with 166 clients (both HIV positive and
negative) at Albion Street Centre (ASC) using a newly-devised questionnaire. Clients
were asked to answer demographic questions, rate their levels of satisfaction with each
aspect and each HCP category, and provide suggestions for improvement. Quantitative
statistical analysis was conducted to obtain a general view of client satisfaction levels.
Dissatisfaction and unmet needs of clients were then investigated in-depth in the second
phase of the research through qualitative face-to-face semi-structured interviews.
Twenty-two clients (both HIV positive and negative) at ASC were interviewed individually
and asked about their attitudes, perceptions, and experiences towards their HCP and
the HIV health care services received. Thematic analysis was used to categorise and
interpret the qualitative data.
More than 90% of the clients were satisfied with most of the aspects covered in the
survey, with a mean overall satisfaction score of 84 out of 100. Clients were most
satisfied with the “technical quality” and “interpersonal manner” of the HCP, and were
least satisfied with “waiting time” and “availability of HCP”. The HCP category with which
the clients has the highest level of satisfaction was “nurses” (86%), followed by
“psychologists” (84%), then “doctors” (83%). Clients who were HIV negative, had a full
time job, visited ASC less frequently, or did not possess any type of Health Care Card
were more satisfied with the services overall. No common dissatisfaction or unmet
needs towards HIV health care service were identified.
“Technical quality of HCP” and “the relationship with HCP” were the two most important
determinants of client satisfaction, which outweighed the inconvenience contributed by
the poor availability of HCP and the location of ASC. The maintenance of
“confidentiality/privacy” was shown to be fundamental in HIV health care facilities. The
multi-disciplinary nature of ASC increased the degree of convenience and satisfaction
level among clients.
Suggestions for improvement in client satisfaction levels include increasing the
attractiveness of the physical environment and the variety of educational reading
materials in the waiting area; introducing beverages, and encouraging clients to be
involved in their treatment decisions. Health care administrative staff in particular are
reminded not to neglect the importance of the availability of HCP, accessibility, and
physical environment when establishing a new HIV health care facility.
The mixed method approach (quantitative survey and qualitative interviews) proved
beneficial. It increased the validity of the findings by assessing client satisfaction levels
using more than one method. This enabled clarification of ambiguities noted in the initial
survey through probes used in the interviews, and also allowed investigation of the
determinants of client satisfaction through understanding their experiences in HIV health
care. Future client satisfaction studies would benefit from using this approach.||en|
|dc.publisher||University of Sydney||en|
|dc.publisher||School of Public Health||en|
|dc.rights||The author retains copyright of this thesis.||-|
|dc.title||Client needs and satisfaction in an HIV facility||en|
|Appears in Collections:||Sydney Digital Theses (Open Access)|