Satisfaction of hospitalized psychiatry patients: why should clinicians care?

BACKGROUND The aim of this study was to determine the relationship between inpatient satisfaction and health outcomes, quality of life, and adherence to treatment in a sample of patients with schizophrenia, while considering key sociodemographic and clinical confounding factors. METHODS This cross-sectional study was conducted in the psychiatric departments of two public university hospitals in France. The data collected included sociodemographic information, clinical characteristics, quality of life (using the 36-Item Short Form Health Survey), nonadherence to treatment (Medication Adherence Report Scale), and satisfaction (a specific self-administered questionnaire based exclusively on patient point of view [Satispsy-22] and a generic questionnaire for hospitalized patients [QSH]). Multiple linear regressions were performed to assess the associations between satisfaction and quality of life and between satisfaction and nonadherence. Two sets of models were performed, ie, scores on the Satispsy-22 and scores on the QSH. RESULTS Ninety-one patients with schizophrenia were enrolled. After adjustment for confounding factors, patients with better personal experience during hospitalization (Satispsy-22) had a better psychological quality of life (SF36-mental composite score, β=0.37; P=0.004), and patients with higher levels of satisfaction with quality of care (Satispsy-22) showed better adherence to treatment (Medication Adherence Report Scale total score, β=-0.32; P=0.021). Higher QSH scores for staff and structure index were linked to better adherence with treatment (respectively, β=-0.33; P=0.019 and β=-0.30; P=0.032), but not with quality of life. CONCLUSION Satisfaction was the only factor associated with quality of life and was one of the most important features associated with nonadherence. These findings confirm that satisfaction with hospitalization should not be neglected in clinical practice and that it may improve the management of patients with schizophrenia.