title: Perceived needs and satisfaction with care in people with multiple sclerosis: a two-year prospective study.
abstract: BACKGROUND
  Considering the costs of multiple sclerosis (MS), it is crucial that the health-related services supplied are in accordance with needs as they are perceived by people with MS (PwMS). Satisfaction with care is related to quality of care and can provide health care providers with the means for improvement. The aim was to explore the perceived needs and satisfaction with care amongst PwMS over a two-year period, also taking sex and disease severity into consideration.
  
  
  METHODS
  The sample consisted of 219 outpatients at a MS specialist clinic. Data on perceived needs and satisfaction with care were collected every six months using a questionnaire which included various dimensions of care. The data was analysed for the whole sample and on an individual level, as well as in subgroups with regard to sex and disease severity.
  
  
  RESULTS
  There were no statistically significant variations in the proportion of PwMS with perceived needs concerning different health-related services during the study period. However, individual variations were found with regard to both perceived needs and satisfaction with care. Few PwMS perceived a continuous need for a specific service. However, the majority perceived a need for rehabilitation, assistive devices, transportation service for the disabled, psychosocial support/counselling and information on social insurance/vocational rehabilitation at least sometimes. Severe MS was associated with a greater perceived need for almost all the services studied and women experienced a need for psychosocial support/counselling to a greater extent than men. In relation to the different categories of health care staff, PwMS were most satisfied with nurses with regard to all dimensions of care. They were least satisfied with the availability of psychosocial support/counselling; and information about social insurance/vocational rehabilitation.
  
  
  CONCLUSIONS
  Despite the large proportion of individuals with mild disease severity in our sample, a considerable number of needs were identified of which many, on an individual level, varied over time. Key services demanded by PwMS were identified. Also the level of satisfaction with care varied and areas with a potential for improvement were identified such as the availability of rehabilitation services including an increase in the supply of psychosocial support and counselling.
authors.affiliation: Department of Clinical Neuroscience, and Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden. charlotte.ytterberg@ki.se
authors.forename: Charlotte
authors.initials: C
authors.lastname: Ytterberg
authors.forename: Sverker
authors.initials: S
authors.lastname: Johansson
authors.forename: Kristina
authors.initials: K
authors.lastname: Gottberg
authors.forename: Lotta Widén
authors.initials: LW
authors.lastname: Holmqvist
authors.forename: Lena
authors.initials: L
authors.lastname: von Koch
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D019538:Health Care Surveys / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000453:epidemiology / Q000473:pathology / Q000628:therapy*; D010045:Outpatients / Q000706:statistics & numerical data; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012720:Severity of Illness Index; D012737:Sex Factors; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology