Health for life

Had a bad day? Extending your normal exercise routine by a few minutes may be the solution, according to Penn State researchers, who found that peoples satisfaction with life was higher on days when they exercised more than usual.

"We found that peoples satisfaction with life was directly impacted by their daily physical activity," said Jaclyn Maher, graduate student in kinesiology. "The findings reinforce the idea that physical activity is a health behavior with important consequences for daily well-being and should be considered when developing national policies to enhance satisfaction with life."

The team examined the influence of physical activity on satisfaction with life among emerging adults ages 18 to 25 years because this populations sense of well-being appears to worsen more quickly than at any other time during adulthood.

"Emerging adults are going through a lot of changes; they are leaving home for the first time and attending college or starting jobs," said Maher. "As a result, their satisfaction with life can plummet. We decided to focus on emerging adults because they stand to benefit the most from strategies to enhance satisfaction with life."

The researchers recruited two groups of college students at Penn State. The first group, consisting of 190 individuals, entered information into a diary every day for eight days. The second group, consisting of 63 individuals, entered information into a secure website every day for 14 days. Both groups answered questions aimed at determining participants satisfaction with life, physical activity and self-esteem. The personalities of all participants in the first group were assessed at the outset of the study using the Big Five Inventory short form.

For the second group (the 63 individuals who filled out questionnaires online for 14 days), the researchers wanted to further investigate whether physical activity was indeed, the cause of participants increased satisfaction with life rather than some other factor such as mental health, fatigue, or Body Mass Index.

"Shifts in depression, anxiety and stress would be expected to influence a persons satisfaction with life at any given point in time," said David Conroy, professor of kinesiology. "In addition, fatigue can be a barrier to engaging in physical activity, and a high Body Mass Index associated with being overweight may cause a person to be less satisfied in a variety of ways."

By controlling for these variables, the researchers were able to determine that the amount of physical activity a person undertakes in a particular day directly influences his or her satisfaction with life. Specifically, the team found that by exercising just a little more than usual a person can significantly improve his or her satisfaction with life.

The results appeared online this week in the journal Health Psychology.

"Based on these findings, we recommend that people exercise a little longer or a little harder than usual as a way to boost satisfaction with life," said Conroy.

Years ago, the Disease Management Care Blog crossed swords with a clinic administrator who was unsatisfied with its Departments patient satisfaction metrics. The DMCB argued sometimes having to say "no" to patients demands for easy cures, specialist errals, sophisticated imaging studies or off-formulary drugs could result in low satisfaction rates. It was about then that the DMCB was informed that the patient satisfaction surveys were going to be tied to portion of its income.

Administrator: 1, DMCB: 0.

Thats why years later, the DMCB feels partially redeemed by an interesting peer-reviewed publication that examines the lack of any relationship between patient satisfaction and patient centered care.  In case you think theyre both the same, think again.

Writing in the July 11 issue of JAMA, authors Joel Kupfer and Edward Bond point out that the former is a consumerist concept that compares service or product delivery to customers expectations, while the latter is a medical concept that uses patient values to guide medical decision making.

Its been long-known that exceeding expectations leads to customer loyalty which, in turn, leads to greater profits. Thats one of the reasons why business-minded hospital administrators typically rely on satisfaction surveys as a key metric of success. Despite their wide use in health care settings, however, Drs. Kupfer and Bond find that "satisfaction" is a poorly researched concept that has little correlation with the important domains of quality, safety, effectiveness, efficiency or equitability. For example, its possible for over-testing and over-prescribing to give patients the false impression of action and progress. In addition, because patients dont usually bear the full cost of medical care, their opinions dont have to reconcile price and product, like they would for a car or a bottle of shampoo.

What did the DMCB learn, other than, once again, it was right all along?

1. Building a patient centered medical care practice wont necessarily generate high patient satisfaction. Conversely, pursuing high satisfaction rates is not the same as initiating patient centered medical care.

2. "Patient satisfaction rates" are a Ver. 1.0 primitive window into one slice of patient experience that, by itself, ultimately offers little insight about overall quality.  Patients and their doctors deserve better.