Influence Factors of Effective Communication of Health Officers on Patient Satisfaction

ABSTRACT


INTRODUCTION
In the era of globalization, there is intense competition in almost all sectors, one of which is the hospital which is a provider of health services for patients so that hospitals must be able to meet these needs by improving the quality of better services oriented to efforts to increase patient satisfaction by paying attention to human resources.human resources (HR) in providing health care services at the hospital.Hospitals as health care facilities for the community are places that have a high risk of unsafety so they must strive to improve safety for all those in their environment, especially increasing effective communication in health services.Hospitals are increasingly aware of the importance of improving the quality of care and patient safety so many have implemented interventions to reduce the number of adverse events and the World Health Organization (WHO) has indicated patient safety as a priority in the health care system.Where patient safety is a core component in patient care.However, a number of medical errors often occur in health facilities.
The National Standard for Hospital Accreditation (SNARS) compiles patient safety standards (SKP.2-SKP2.2) so that hospitals develop communication methods that are considered effective when timely, accurate, complete, unambiguous (ambiguous) and accepted by recipients of information aimed at reducing misinformation and improve patient safety.The aspect that is quite dominant in influencing the patient's decision to seek treatment at health services is effective communication.The attitude of health workers in communicating with patients can lead to conclusions that will affect the patient's decision to seek treatment.Health workers need to have the ability to multiply and exchange information verbally and non-verbally with patients of all

METHODS
The design of this research is an analytical survey research with a cross sectional approach, namely a research design that is carried out at one time only requires a relatively short time used to find the relationship between the independent variable and the dependent variable.This research will be conducted at the outpatient clinic of Cut Meutia General Hospital, North Aceh Regency, Aceh Province.The location of this research was chosen with the consideration that RSU Cut Meutia is a district referral hospital that has included a Regional Work Unit (SKPD) with the status of a Regional Public Service Agency (BLUD) in North Aceh district.The population in this study amounted to 13,173 outpatients.The sample in this study used Accidental Sampling, totalling 100 outpatients.Based on table 4.1 above, it is known that the majority of the 100 respondents aged 26-35 years were 44 respondents (44%) and the minority aged >45 years were 17 respondents (17%).In the education category, the majority of respondents have SMA/SMK education as many as 49 respondents (49%) and the minority of respondents with Academy/University education are 15 respondents (15%).Meanwhile, in the occupational category, the majority of respondents worked as self-employed as many as 51 respondents (51%) and the minority of respondents did not work as many as 8 respondents (8%).

Respect
The results of the research and explanations of respondents' answers based on the Respect variable can be seen in the following Based on the table above 4.6 above, it can be seen that most effective communication based on Humble at Cut Meutia General Hospital, North Aceh Regency, Aceh Province, the majority answered not well as many as 87 respondents (87%) and a good minority answered 13 respondents (13%).

Outpatient Satisfaction
The results of the study and explanations of respondents' answers based on the outpatient satisfaction variable can be seen in the following table : Table 4 Based on table 4.7 of the 100 respondents the majority answered dissatisfied as many as 90 respondents (90%) and the minority of respondents who answered satisfied were 10 respondents (10%).

Bivariate Analysis Results
In this study, bivariate analysis aims to determine the relationship between the independent variable and the dependent variable.Based on the results of the chi-square test analysis shows that the significant value of the probability of respect is p-value = 0.009 or <0.05.This proves that Respect has a relationship with patient satisfaction at the Cut Meutia General Hospital, North Aceh Regency.Based on the results of the chi-square test analysis shows that the significant value of the probability of empathy (Empathy) is p-value = 0.003 or <0.05.This proves that empathy has a relationship with patient satisfaction at the Cut Meutia General Hospital, North Aceh Regency.Based on the results of the chi-square test analysis shows that the significant value of the probability of humble (Friendly) is p-value = 0.000 or <0.05.This proves that humble has a relationship with patient satisfaction at the Cut Meutia General Hospital, North Aceh Regency.

Multivariate Analysis Results
To determine the relationship of independent variables to patient satisfaction simultaneously, multivariate analysis was carried out using binary logistic regression test by first selecting potential variables to be included in the model.Variables that were selected as candidates or considered significant that had a p-value <0.05 in the bivariate test were then included together in the multivariate test.Based on the bivariate test in this study, it showed that all variables (Respect, Empathy, Audible, Clarity, Humble) met the requirements to be used as model candidates in the binary logistic test.Empathy has a relationship with outpatient satisfaction at RSU Cut Meutia, North Aceh Regency with a p value = 0.008 and an OR value of 11,401 meaning that respondents who give an opinion about the importance of Empathy have 11 times the opportunity to affect outpatient satisfaction.Audible has a relationship with outpatient satisfaction at RSU Cut Meutia, North Aceh Regency with a p value = 0.004 and an OR value of 11.500, meaning that respondents who give an opinion on the importance of Audible have 11 times the chance to affect outpatient satisfaction.Clarity has a relationship with outpatient satisfaction at RSU Cut Meutia, North Aceh Regency with a p value = 0.001 and an OR value of 6355, meaning that respondents who give an opinion about the importance of Clarity have 6 times the chance to affect outpatient satisfaction.Humble has a relationship with outpatient satisfaction at RSU Cut Meutia, North Aceh Regency with a p value = 0.002 and an OR value of 2,991, meaning that respondents who give an opinion about the importance of Humble have 3 times the chance to affect outpatient satisfaction.

Respect Relationship with Patient Satisfaction
The results showed that there was a relationship between Respect and outpatient satisfaction.The results of this study are in line with the results of Indri Primadianty's (2020) research.The results of this study indicate that there is a statistically significant effect of respect with p-value 0.002 <0.05 with patient satisfaction at the Inpatient Installation of Massenrempulu General Hospital, Enrekang Regency.Based on the analysis of respect related to patient satisfaction, health workers (doctors, nurses and midwives) notify the examination that will be carried out and maintain patient privacy.Meanwhile, respect is not related to patient satisfaction because health workers do not shake hands and invite patients to sit down because they are still in the Covid pandemic situation which caused a ban on shaking hands.This is in line with Indri Primadianty's research (2020) which states that the effect of nurse therapeutic communication in the respect dimension has a significant effect with a p-value of 0.002 <0.05 with patient satisfaction at the Inpatient Installation of Massenrempulu General Hospital, Enrekang Regency.Which discusses nurses.Those who have communication skills will not only find it easy to establish a trusting relationship with the patient but also prevent illegal problems from occurring.This study is in contrast to research conducted at the Inpatient Installation of Petala Bumi Hospital, Riau Province.Which concluded that the attitude of respect had no relationship where nurses who did not have an attitude of respect could be replaced with the attitude of respect for other nurses due to the high workload of nurses making nurses sometimes give their duties to nurses with nurse changes not being a barrier for patients to get and achieve services from nurses.The role of respect in effective communication on patient satisfaction is good, but its role in educating patients and families has not been maximized, this is due to a lack of information and respect for health workers regarding the choice of treatment and therapy that patients want to do.

Empathy Relationship with Patient Satisfaction
The results showed that there was a relationship between empathy and outpatient satisfaction.The results of this study are in line with the results of research (Peratiwi et al., 2021), The results of this study indicate that there is an effect of empathy with a p-value of 0.000 <0.05 with patient satisfaction in the ER Sri Pamela Hospital, Tebing Tinggi City.Based on the analysis, Empathy (empathy) related to patient satisfaction is that health workers are able to understand each patient's complaint well.While empathy is not related to patient satisfaction because health workers are not serious and listen carefully to patient complaints because the complaints submitted every patient visit are always similar which causes health workers to lack empathy when responding to them.
This study is to research (Aulia, 2021), the results of statistical tests using the Chi-Square test obtained p-value = 0.056> 0.05.There is no significant relationship between empathy and patient satisfaction at the Landasan Ulin Health Centre in 2021.Which discusses the dimensions of service quality, especially in maintaining patient privacy and increasing the speed of dialling queue numbers at the counter, increasing the number of seats and good sanitation for patient satisfaction.The role of empathy in service quality to patient satisfaction at At-Medika Palopo Hospital is quite good, but the quality factor of hospital services still needs to be improved, especially the role of empathy by giving full attention and understanding the needs of patients and acting in the interests of patients and always helping without being asked.

Audible Relationship with Patient Satisfaction
The results showed that there was a relationship between Audible and patient satisfaction.The results of this study indicate that there is an audible effect with a p-value of 0.001 <0.05 on the satisfaction of inpatients at A.W Sjahranie Hospital Samarinda 2019.Based on the Audible analysis, related to patient satisfaction, health workers who provide sufficient time for examination and consultation related to patient complaints (Yudia,2019).While Audible is not related to patient satisfaction because patients cannot see and know the identity of health workers because health workers do not use their identification which causes patients to feel less satisfied when served.
Communication effectiveness is influenced by audible factors on satisfaction in conventional contrast examination patients at the Radiology Installation of Arifin Achmad Hospital Riau Province categorized as satisfied, but in conventional contrast examination communication effectiveness is needed to explain the procedures, benefits, risks and examination preparation so that there is no dissatisfaction with communication.because they feel they do not understand the instructions and explanations given, the explanation is less structured, and there are still components or language that are difficult for the patient to understand (Amelia, 2021).

Clarity's Relationship with Patient Satisfaction
The results showed that there was a correlation between Clarity (Clear) with outpatient satisfaction.The results of this study are in line with the research results (Jannah et al., 2018), the results of the study illustrate that Clarity has a simultaneous effect on patient satisfaction at the Radiology Installation with a P-value of 0.000 <0.05.Based on the Clarity analysis (Clearly) related to patient satisfaction, health workers (doctors, nurses and midwives) explained about the patient's condition in easy-to-understand sentences without noise in the room.Meanwhile, Clarity is not related to patient satisfaction because health workers do not explain the benefits and side effects of drugs that have been prescribed so that patients do not know the effectiveness of the drug content to be consumed.
The relationship between waiting time and clarity of information (Clarity) with patient satisfaction in the Emergency Installation of RSUD DR.Achmad Mochtar Bukit Tinggi in 2018 was categorized as unsatisfied due to long waiting times and the lack of clarity (clarity) of the This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.expected information.It is hoped that the hospital can add nurses who have certificates as emergency nurses so that patients visiting the ER can be handled quickly and can provide explanations according to SOPs with a good attitude to patients, so that in the end it can increase patient satisfaction.(Riyanti, 2018)

Humble's Relationship with Patient Satisfaction
The results showed that there was a relationship between Humble (Friendly) and patient satisfaction.The results of this study are in line with the research results (Subroto et al., 2021), The results of this study indicate that there is a statistically significant influence of humble with the largest percentage of 67.5% getting results <0.05 with the effect of effective communication on patient satisfaction at the Physiotherapy Installation of the Hospital, Dr H. Soemarno Sosroatmodjo Kuala Kapuas.Based on the Humble analysis (Friendly) related to patient satisfaction, health workers (doctors, nurses and midwives) are friendly and open to patient complaints.Meanwhile, Humble is not related to patient satisfaction because health workers do not inform the patient when the consultation and examination has been completed, only busy continuing pending matters so that the patient is confused by the attitude of the officer.
This study contradicts research at inpatient installation hospitals.which concludes that humble has no relationship where nurses have a high workload which will make the performance of nurse's rush to complete their duties so that nurses are sometimes not gentle in dealing with patients so that patients make mistakes.understand and assume the nurse is not friendly to him.(Yuliana et al., 2020) The role of humble in the effectiveness of nurse communication to patients at Teungku Fakinah Hospital Banda Aceh is in the good category at 89%, namely humble is in the good category, but its role in educating patients and families is not optimal, this is because health workers tend to use technical language in the workplace because they think the tone of communication should always be professional.Communication aimed at patients must be concise, precise, simple and clear because health workers must assume the responsibility to communicate in accordance with the patient's health knowledge so as to create patient satisfaction.

CONCLUSION
There is an influence of the Respect factor in the effective communication of health workers on the satisfaction of outpatients at the Cut meutia General Hospital, North Aceh Regency, Aceh Province where with Respect, patients can be motivated and supported by the Respect attitude of officers who respect and appreciate it which leads to satisfaction and patients encouraged to recover quickly and routinely carry out treatment.Where Respect is the dominant factor related to outpatient satisfaction at the Cut Meutia General Hospital, North Aceh Regency, Aceh Province.There is an influence of the Empathy factor in the effective communication of health workers on the satisfaction of outpatients at the Cut meutia General Hospital, North Aceh Regency, Aceh Province where with the presence of Empathy, the patient has a sense of being cared for, understood and understood when taking treatment so that patients feel satisfied in the services provided given.
There is an influence of the Audible factor in the effective communication of health workers on the satisfaction of outpatients at the Cut meutia General Hospital, North Aceh Regency, Aceh Province where with Audible the patient feels heard and understood well when taking treatment because the patient feels helped in exchanging information for health so that it can help determine the level of patient satisfaction in receiving the services that have been provided.There is an influence of the Clarity factor in the effective communication of health workers on the satisfaction of outpatients at the Cut meutia General Hospital, North Aceh Regency, Aceh Province where with Clarity the patient feels that he gets clarity about his illness so that the patient will have more insight, broad experience and ways good thinking and ways of acting that give birth to satisfaction in the treatment process being undertaken.
There is an influence of the Humble factor in the effective communication of health workers on the satisfaction of outpatients at the Cut meutia General Hospital, North Aceh Regency, Aceh Province where with the Humble attitude, the patient has a great sense of trust and a great desire to recover because of the friendly attitude of the officers followed by patient satisfaction.in the services provided and beliefs about the efficacy of treatment will influence patients to choose to complete their treatment.

SUGGESTION
It is hoped that health workers should be more respectful of each other when serving patients so that patients do not complain of unfriendly officers in carrying out their roles so that they can provide satisfaction for patients.It is expected that health workers are able to be empathetic where patients feel understood and so that patients do not feel less responsive and less understood by officers as a result, they do not form the patient's desire to listen and are motivated to accept all alternative treatments that will be given and instructions for healing for their illness.It is hoped that health workers will be able to process information into audio-visual form or demonstrate it with certain tools to make it easier for patients to understand and understand the information and education delivered so as to achieve the same understanding in order to improve healing and patient satisfaction.
It is expected that health workers are able to explain in a sequential, open and transparent manner any information related to the clarity of diagnosis, clarity of drugs and their side effects and benefits so that patients do not complain of ignorance in an accurate and detailed manner regarding the disease and the drugs they are taking who only know to take their medicine regularly as recommended.delivered without the patient's own awareness to recover.It is expected that health workers will be able to apply a humble and friendly attitude so that patients do not complain that the officers are rude, curt and arrogant in providing services both counselling and health education.Because with a humble attitude, health workers have an open and friendly attitude that encourages patients to be determined and have the confidence to follow the directions/instructions for treatment so as to lead to patient satisfaction which is marked by the return of patients for comprehensive and sustainable treatment to completion.

table : Table 4
EmpathyThe results of the research and explanations of respondents' answers based on the Empathy variable can be seen in the following table: answered not well as many as 84 respondents (84%) and the minority answered well as many as 16 respondents (16%).

Table 4
Table 4.8 Cross Tabulation Between Respect and Satisfaction of Outpatients at RSU Cut Meutia, North Aceh Regency Table 4.9 Cross Tabulation Between Empathy and Outpatient Satisfaction at RSU Cut Meutia, North Aceh Regency

2022 Audible Relationship with Outpatient Satisfaction
Table 4.10 Cross Tabulation Between Audible and Outpatient Satisfaction at RSU Cut Meutia, North Aceh Regency Based on the results of the chi-square test analysis shows that the significant value of the Audible probability is p-value = 0.000 or <0.05.This proves that audible has a relationship with patient satisfaction at the Cut Meutia General Hospital, North Aceh Regency.Clarity's Relationship with Outpatient Satisfaction Table 4.11 Cross Tabulation Between Clarity and Outpatient Satisfaction at RSU Cut Meutia, North Aceh RegencyBased on the results of the chi-square test analysis shows that the significant value of the clarity probability (clear) is p-value = 0.001 or <0.05.This proves that clarity has a relationship with patient satisfaction in the hospital.
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.Jurnal Perilaku Kesehatan Terpadu Vol 1 No 1

Table 4 .
The results of multivariate analysis with multiple logistic 14 shows that after the binary logistic regression test, the dominant factors most related to patient satisfaction were Respect (OR = 17,159), Audible (OR = 11,500), Empathy (OR = 11,401), Clarity (OR = 6,355) and Humble (OR=2,991) <0.05.That is, it is known that all of these variables are correlated with outpatient satisfaction at RSU Cut Meutia, North Aceh Regency, Aceh Province.Respect has a relationship with outpatient satisfaction at RSU Cut Meutia, North Aceh Regency with a p value = 0.006 and an OR value of 17,159, meaning that respondents who give an opinion on the importance of respect have 17 times the opportunity to influence outpatient satisfaction.
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.