Emergency Patient Complaints in Turkish Patients

  

    
Approaches 
    
χ2 Test (P) 
  
  

    
Physicians 
    
Nurses 
  
  

    
Introduced self 
    
Introduced self 
  
  

    
N (%) 
    
N (%) 
  
  

    
Not at all satisfied 
    
3(0.2) 
    
78(5.2) 
    
p=.0001a 
  
  

    
satisfied 
    
617(40.8) 
    
402(26.6) 
  
  

    
Very satisfied 
    
894(59.0) 
    
1034(68.3) 
  
  

    
Explained treatment and procedures    that 
      
were /would be done to you 
    
Explained treatment and procedures    that 
      
were /would be done to you 
  
  

    
Not at all satisfied 
    
11(0.7) 
    
46(3.1) 
    
p=.0001a 
  
  

    
satisfied 
    
405(26.8) 
    
339(22.4) 
  
  

    
Very satisfied 
    
1098(72.5) 
    
1129(74.6) 
  
  

    
Came regularly to check on you 
    
Came regularly to check on you 
  
  

    
Not at all satisfied 
    
96(6.3) 
    
42(2.8) 
    
p=.0001a 
  
  

    
satisfied 
    
445(29.4)) 
    
417(27.5) 
  
  

    
Very satisfied 
    
973(64.3) 
    
1055(69.7) 
  
  

    
Polite/respectful behavior 
    
Polite/respectful behavior 
  
  

    
Not at all satisfied 
    
38(2.5) 
    
0 
    
p=.0001a 
  
  

    
satisfied 
    
260(17.2) 
    
201(13.3) 
  
  

    
Very satisfied 
    
1216(80.3) 
    
1313(86.7) 
  
  

    
Communication with you 
    
Communication with you 
  
  

    
satisfied 
    
458(30.3) 
    
201(13.3) 
    
p=.0001a 
  
  

    
Very satisfied 
    
1056(69.7) 
    
1313(86.7) 
  

Table 5:  Comparison of similar statements about physicians and nurses (N =1514).

Discussion

The majorities of the patients in this study was women, were between 16 and 43 years of age, had a university level of education, and had private health insurance. The private hospital research site and the residents of this neighborhood are of a high socioeconomic status. More women (2.3%; n = 20) than men (1.1%; n = 7) complained about the emergency department (Table 3). The reason for this finding may be that there was a higher percentage of female patients in the study or because the women’s expectations were higher [12]. Although there is conflicting evidence in the literature about a patient’s sex having an effect on satisfaction, it has been determined that female patients are more critical of the care they are given than are male patients [12.13]. It was determined that 64.9% of the patients (n = 48) in the 72- to 99-year-old age group were “very satisfied “with the emergency department (Table 3). This result may have been affected by elderly patients in general being more nature and tolerant, valuing communication, and being able to talk comfortably with physicians and nurses, along with the respect shown to the elderly in the social environment by physicians and nurses [14]. The patients’ level of education was not determined to have an effect on patient expectations of satisfaction (Table 3).The reports in the literature do not support this finding, because it is reported that as educational level increases expectations also increase and satisfaction decreases [14,15]. As expected, the data indicated that patients who perceived that their own health problems were very serious also had increased expectations of the ED staff. In turn, these patients also had higher levels of dissatisfaction with wait times and the interpersonal characteristics of physicians and nursing staff. The reason for this is that patients with very serious health problems believe they have more needs and expect all of their needs to be met immediately by health care professionals [16]. When this research was conducted, it was observed that uncertainty was experienced by patients who had to wait for a long period (especially after 4 hours) in the emergency department. They did not feel like they belonged there, which had a negative affection their physical and psychological states. According to a research that was done in Turkey. The result showed that the factors were statistically significant on patient satisfaction were: Doctors and nurses’ experiences-behaviors, cleanliness and decoration of hospital, informing the patients and their relatives, the time perceived and spended for results, giving prescription while being discharged, shape of meeting the patients at the door of emergency department and taking them in. Doctors’ behaviors were the most common factor that affected the patient satisfaction. Nurse behavior, giving information to the patients for procedures while the detailed investigation and treatment going on, cleanliness condition, and giving information while the patient are discharged were the affective factors on patient satisfaction [17]. It is quite natural that patients would consider the emergency department to be a noisy place because of the many procedures done on an urgent basis, the high number of employees in the area, and the continual communication occurring between staff. In this study, some of the patients complained that there were curtains between the beds in the rooms. The reason for this complaint may be that the curtains were not sufficient to protect patients ‘privacy and confidentiality. Based on our research, it appears that patient satisfaction would likely increase if we provided a more private, quieter environment and minimized the shouting that occurs in our work area. While they were receiving health care in the emergency department, patients wanted to be treated like they were people, not objects. For this reason we need to assess their mental and emotional states (ie, anxiety). Patients who were checked on regularly by health care personnel, who were asked how they were and if they needed anything by someone who was smiling, stated that they felt like they had not been forgotten and were satisfied with their care. The emergency department where this research was conducted was in a private hospital used by more people with a high socioeconomic level. For this reason they had different expectations, such as that the emergency department would have a separate parking area, that there would be quicker discharge procedures, and that unnecessary tests would not be done. They expected that they would be given general, brief, and understandable information about their health condition. Moreover, in our observation, this reason would be affected by culture because in general Turks want everything to be done in a short time.

Limitations

The limitations of this research were that only patients who were treated and cared for in the emergency department at the facility that gave permission for the study were included, that patients’ relatives, friends, and visitors were excluded, and that the interviews were conducted in the hospital where they had received treatment and care. The socioeconomic status of these patients could have affected results. A possible bias existed with the survey respondents because they may have wanted to please the surveyor. In turn, there was a regency effect with those who were surveyed before leaving the hospital. Furthermore, future studies should examine differences that exist in the feedback given by ED patients upon discharge compared with those who are surveyed at home several days after discharge.

Conclusion

All ED patients want to receive health care without waiting. This is an expected and desirable situation. However, this request cannot always be met. For this reason, as length of waiting time increases, patients’ dissatisfaction with ED care may increase. The ED health care team is racing against time and may not be able to find enough time to introduce themselves or explain what procedure they are doing. Also, if the patient’s condition is very urgent, he or she may be experiencing in a high level of stress. Therefore, the patient may not understand adequately the self-introduction of the team members or the information they give. When ED patient complaints are considered, the satisfaction level of patient care provide guidance about how to give individualized care in the emergency department.

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