title: Staff affirmations and client criticisms: staff and client perceptions of quality of care at sexually transmitted disease clinics.
abstract: OBJECTIVE
  Public health sexually transmitted disease (STD) clinics play a central role in STD control efforts. This study addressed the perceived quality of client services at two STD clinics in Alabama.
  
  
  OBJECTIVE
  The goal of this study was to evaluate and develop tools for assessment of client satisfaction at STD clinics.
  
  
  METHODS
  Four focus groups of staff (N=16) and clients (N=15) at the clinics were conducted between June and November 2003.
  
  
  RESULTS
  Staff and client assessments of respect, privacy protections, and friendliness at the clinics differed in substantial ways. Clients were concerned with visibility, being stigmatized or disrespected, and about a breach of confidentiality. Concerns about being stigmatized focused mainly on nonclinical staff. The staff did not perceive these concerns to be warranted. Quality of medical care was rated high by both groups.
  
  
  CONCLUSIONS
  Staff-client interactions are an important element of STD care, and "front desk" actions set the tone at public STD clinics. Nonclinicians should receive training to improve body language and other behaviors to alleviate the stigma concerns of clients who are anxious, fearful, and sometimes distrustful of the health system.
authors.affiliation: Department of Criminal Justice and the Institute for Rural Health Research, University of Alabama, Tuscaloosa, Alabama 35487-0320, USA. blichten@bama.ua.edu
authors.forename: Bronwen
authors.initials: B
authors.lastname: Lichtenstein
authors.forename: Laura H
authors.initials: LH
authors.lastname: Bachmann
mesh_terms: D000328:Adult; D000407:Alabama; D000554:Ambulatory Care Facilities / Q000592:standards*; D001291:Attitude of Health Personnel; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D011787:Quality of Health Care; D012749:Sexually Transmitted Diseases / Q000517:prevention & control*