Legal consciousness of psychiatric patients in Israeli hospitals: Awareness and satisfaction.

The paper contributes to the literature on legal consciousness in medical settings by focusing on psychiatric patients' understanding of rights during hospitalization in Israeli psychiatric wards. It asks whether hospital personnel act as agents who promote patients' legal consciousness and whether patients are aware of their legal and social rights during hospitalization. The data for this study were derived from the Patient Experience Survey of Psychiatric Public Hospitals, a comprehensive survey conducted by the Israel Ministry of Health in 2017. The survey included two variables that were used to measure patients' legal consciousness: legal consciousness with hospitalization rights and legal consciousness with social rights. To predict legal consciousness and patient satisfaction, a logistic regression model was employed. The analysis reveals low rates of patients' awareness of hospitalization and social rights, varying between 55 and 66%, respectively. Variations in awareness are not strongly associated with patients' socioeconomic and demographic attributes or with hospital characteristics but are somewhat associated with hospitalization conditions. The data also reveal that awareness of legal rights (whether hospitalization rights or social rights) is likely to increase satisfaction with the hospitalization experience. The analysis underscores a significant finding. Patients' awareness of their legal rights during hospitalization is limited. Interestingly, this awareness is more influenced by the conditions of hospitalization than by the patients' socio-demographic attributes. This research also provides insights into the potential role of legal awareness in shaping patients' attitudes toward treatment and enhancing their satisfaction during hospitalization.

Website posts and the voice of frontline healthcare workers: a thematic analysis.

PURPOSE: With the soaring rise in popularity of social media platforms in recent decades, the use of website posts for the expression of work-related views has also increased. Despite websites being extensively used, there has been no examination of the views and concerns expressed by frontline workers through website posts. The present research aims to contribute to the "voice literature" first by evaluating how frontline workers utilize anonymous media platforms to express their views and work-related concerns and, second, by demonstrating how anonymous voice systems can encourage frontline health workers in providing feedback and dissatisfaction. DESIGN/METHODOLOGY/APPROACH: The study utilizes the thematic analysis method to analyze the content of posts by psychologists on a collaborative consultation website administrated by Israel's Ministry of Health, discussing their perceptions of work-related concerns. FINDINGS: The analysis identified three work-related themes through the employees' voices. These include insufficient support from management, conflicts and excessive occupational demands. The workers expressed their apprehension with regard to organizational pressures, deficient budget allocations, excessive workloads, lack of recognition and work-life imbalances. ORIGINALITY/VALUE: The application of thematic analysis method to anonymous open-public data should be viewed as an effective, affordable, genuine and unique research method for data analysis. Anonymous platforms can generate unique insights that may not be possible through traditional means. This can provide practitioners with a comprehensive understanding of various issues and challenges and be a useful tool for identifying shortcomings within health settings.

Responsiveness of inpatient care and provision of dignity: Insights from a patient experience survey in Israel.

The paper contributes to the literature on the responsiveness of care, patient dignity, and disparities in the provision of health services. It does so by evaluating indicators of patient responsiveness while focusing on aspects of dignified treatment. The data were taken from the Patient Experience Survey of General Public Hospitals conducted by the Israel Ministry of Health in 2018. The analysis focuses on two indicators of responsiveness (i.e., actual) and three indicators of patient satisfaction with responsiveness (i.e., satisfaction). The analysis reveals that variations of these indicators are associated with patients' sociodemographic attributes and the hospitals' characteristics. However, while the likelihood of the actual provision of responsive care tends to be lower for vulnerable patients, the satisfaction of vulnerable populations with responsiveness tends to be higher. The data also reveal that the likelihood of responsive treatment and patient satisfaction with this tends to be lower for patients hospitalized in smaller hospitals and hospitals located in the periphery. The findings and their meaning are discussed in the context of studies on responsiveness of care, health disparities, dignified treatment, and patient satisfaction with the provision of health services.

Unhealthy Immigrants: Sources for Health Gaps Between Immigrants and Natives in Israel.

The study focuses on sources for health gaps between Jewish immigrants and native-born Israelis. Unlike traditional immigrant societies where immigration is viewed as economically motivated, immigrants returning to Israel are viewed as the "returning diaspora". Because immigrants in Israel are entitled to the same health benefits and medical services as native-born, we expect Israel to attract unhealthy immigrants in disproportionate numbers. The data for the analysis are obtained from the Israeli National Health Interview Survey (2013-2015). The data set provides detailed information on health status and illness, sociodemographic attributes and origin of immigrants. Three major origin groups of immigrants are distinguished: the former Soviet Union, Western Europeans or the Americans (mostly Ashkenazim), and Asians or North Africans (mostly Sephardim). Our findings lend support to the expectations that the health status of all immigrant groups is poorer than that of native-born Israelis. The nativity-illness gap is most pronounced in the case of male immigrants (from Europe or the Americas or South Africa or Australia) and for female immigrants (from countries in the Middle East or North Africa) and least pronounced in the case of immigrants arriving from the former Soviet Union for both gender groups. Decomposition of the gaps into components reveals that some portion of the illness gap can be attributed to nativity status, but the largest portion of the gap is attributed to demographic characteristics. Neither socioeconomic status nor health-related behavior accounts for a substantial portion of the nativity-illness gap for all subgroups of immigrants.

Complaints and Satisfaction of Patients in Psychiatric Hospitals: The Case of Israel.

The main objective of the research is to advance knowledge in the field of patient experience. First, the research provides a classification of verbal responses by patients to an open-ended question (using content analysis) into distinct categories of concerns and complaints; and second, it examines (using regression analysis) the extent to which different types of complaints exert a differential impact on the level of patient satisfaction. The content analysis reveals that patient voice extends across a wide variety of issues, including complaints regarding physical conditions of the facility, quality of food, cleanliness, caregiver attitudes, availability of medical staff, lack of communication with staff, malpractice, and lack of privacy and respect. Linear regression analysis reveals that patients who complained about the hospitalization experience, especially complaints about interpersonal relations, are less likely to express satisfaction regarding hospitalization. The findings underscore the importance of patient's complaints for understanding patient satisfaction (or dissatisfaction) with hospitalization. Patients' complaints, especially in the area of interpersonal relations, are found to be consequential for the patient level of satisfaction.

The voice of patients in Israel's general hospitals.

PURPOSE: The purpose of this study is to capture the variety of issues that concern patients and to examine the extent to which personal characteristics of patients, such as education, ethnicity, age, gender and conditions of hospitalisation, influence the tendency to "express (negative) voice" and raise "critical views". DESIGN/METHODOLOGY/APPROACH: Using data obtained from the 2014 Survey of Health Satisfaction in Israel, the study focuses on patients' responses to an open-ended question regarding the medical care experience in hospitals. FINDINGS: The analysis reveals that "the voice of patients" spreads across a wide variety of issues, including the physical condition of the hospital and caregiver behaviour. Multivariate regression models show that subgroups with greater access to social and economic resources (i.e. in Israel, individuals who are Jewish), academics, women and younger patients are more likely to express critical voice regarding the hospitalisation experience. Likewise, inferior hospitalisation conditions are likely to increase expression of negative "voice" and criticism. ORIGINALITY/VALUE: The findings underscore the importance and value of open-ended questions in evaluating healthcare satisfaction, suggesting that the likelihood of expressing critical voice is higher among patients of high socio-economic status - perhaps because they are more likely to expect, demand and feel entitled to high-quality care. Likewise, inferior hospitalisation conditions increase the critical voice.

The importance of combining open-ended and closed-ended questions when conducting patient satisfaction surveys in hospitals.

Background: Using data obtained from the National Satisfaction Survey in General Hospitals, 2014, the present study examines patients' satisfaction with medical care and hospitalization conditions in the public hospitals in Israel. Using the framework of 'voice' expression the study examines the added-value of analyzing verbal responses to gage patient satisfaction. Methods: The analysis utilizes a series of closed-ended questions to construct indexes of patients' satisfaction with medical doctors, nursing staff, and hospitalization conditions for a sample of 11,098 patients who were hospitalized in the 25 public hospitals. In addition, a content analysis was applied to the verbal responses (open ended question) to create categories of complaints. Using logistic regression models, we analyzed the social and demographic correlates of high satisfaction, and estimated the relationship between verbal complaints and satisfaction scores. Results: Analysis of the satisfaction measures shows very high levels of patient satisfaction coupled with low variance. Yet, detailed analysis of responses to an open-ended question reveals considerably more critical assessments of the hospitalization experience. Conclusion: The findings illustrate the limitations of closed-ended satisfaction items as the sole instrument for assessing the quality of medical care and underscore the value of the use of mixed methods as a more nuanced approach.