title: Photocoagulation for diabetic retinopathy: determinants of patient satisfaction and the patient-provider relationship.
abstract: OBJECTIVE
  To assess satisfaction with photocoagulation treatment in diabetes patients and to investigate how it relates to patient-related characteristics and patients' visual ability. Further, to observe the interaction between physician and patient and suggest ways to improve the patient-provider relationship and, thereby, treatment satisfaction.
  
  
  METHODS
  This open longitudinal study included 123 diabetes patients undergoing first photocoagulation treatment for diabetic maculopathy or proliferative retinopathy. The Diabetes Treatment Satisfaction Questionnaire (DTSQ) was completed by all patients. Communication, scheduling and adherence scores were defined for each physician-patient pair. Outcome measures were: the patient's overall satisfaction with laser treatment; the patient's degree of satisfaction in relation to visual results; communication, scheduling and adherence scores, and visual acuity results.
  
  
  RESULTS
  The level of satisfaction after initial photocoagulation treatment was high; 46.4% of patients with proliferative retinopathy and 53.1% with maculopathy scored 31 or higher. Although 69.5% of all patients reported that their expectations of treatment corresponded to their final 9-month visual results, only 8.7% of these patients reported an improvement in visual acuity after 9 months. The number of unwanted actions performed by the patients during treatment were significantly related to the number of unclear instructions given by the physician (Fisher's exact test P < 0.01).
  
  
  CONCLUSIONS
  A high level of satisfaction was observed, despite the minimal improvements in visual acuity. Attempts to further improve patient satisfaction might focus on improved education of patients on the possible benefits of laser treatment, greater care in communicating information during treatment, additional nursing support, and additional clerical time to communicate with patients before each appointment.
authors.affiliation: Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.
authors.forename: Maneli
authors.initials: M
authors.lastname: Mozaffarieh
authors.forename: Thomas
authors.initials: T
authors.lastname: Benesch
authors.forename: Stefan
authors.initials: S
authors.lastname: Sacu
authors.forename: Katharina
authors.initials: K
authors.lastname: Krepler
authors.forename: Robert
authors.initials: R
authors.lastname: Biowski
authors.forename: Andreas
authors.initials: A
authors.lastname: Wedrich
mesh_terms: D000328:Adult; D000368:Aged; D003930:Diabetic Retinopathy / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006282:Health Personnel; D006801:Humans; D017075:Laser Coagulation; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D014792:Visual Acuity / Q000502:physiology