Scarcity and Mental Health—Multiple Mediators of Sleep Quality and Life Satisfaction

Background:In the current social environment,scarcity,as a universally present objective state,profoundly impacts individuals’decision-making and health through the subjective feeling it induces,known as a“scarcity mindset.”Particularly,the feeling of scarcity related to money and sleep time is not only widespread but also directly linked to an individual’s mental health.Purpose:This study aims to delve into the relationship between the feeling of scarcity and mental health,with a specific focus on the relationship between the feeling of money scarcity or sleep time scarcity and mental health,as well as the role of sleep quality or life satisfaction in this relationship.Procedure:We determined the sampling quotas based on the population and economic development levels of each province in the“China Statistical Yearbook(2021)”(National Bureau of Statistics,2021).Participants were selected using the Probability Proportional to Size(PPS)sampling method.Data was collected by distributing online questionnaires to participants,and the relationships between the main variables were explored using structural equation modeling.Results:1.In China,the feeling of sleep time scarcity is stronger than the feeling of money scarcity among the public.2.The feeling of money scarcity is positively correlated with depression and anxiety,whereas the feeling of sleep time scarcity is only positively correlated with depression.3.The feeling of scarcity mainly leads to depression and self-denial through reducing life satisfaction,and it leads to anxiety through reducing sleep quality.Conclusion:The feeling of scarcity in money and sleep time is related to different dimensions of mental health.Therefore,reasonably planning financial allocation and ensuring an adequate amount of sleep can reduce the sense of scarcity,thereby improving mental health.Additionally,improving sleep quality and increasing life satisfaction can alleviate the adverse effects of scarcity on mental health.

The Chinese Consumers’Service Quality Satisfaction Differences of Cruise Tourism and Precision Marketing Strategy

The paper selected Chinese Cruise Line as the case study. Having based on the survey data of Chinese cruise tourism consumers, the factor analysis method, one-way analysis of variances method, cluster analysis method, and other quantitative and qualitative methods were taken to analyze Chinese consumers’ satisfaction differences of cruise tourism service quality with different segmentation markets and clusters markets, and the reasons of satisfaction differences were also explored. Then precision marketing strategy of Chinese cruise tourism with different segmentation markets and clusters markets from the supply-side reform perspective was discussed. The purpose of current research was to provide suggestions of precision management and precision marketing of Chinese cruise tourism for relevant enterprises and government departments.

The Digitization of Public Services and Its Contribution to the Quality of Service in Relation to User Satisfaction

In recent years, some governments have been working on solutions to transform public administrations and provide high-quality services to users. The United Nations has recommended integrating digital technology into various aspects of life, including public services. The objective is to offer real-time, high-quality digital services, improve the delivery of public services, enhance their effectiveness and efficiency, while achieving objectives such as transparency, interoperability and citizen satisfaction. However, most governments in developing countries are unable to keep up with this trend. As a result, they often create digital public services that fall short of users’ expectations. This study aims to identify the fundamental factors influencing the quality of service in relation to user satisfaction and to explore the relevance of digital technology in implementing this quality within Cameroon public administrations. To achieve this, we used a qualimetric research method, which included non-directive interviews, questionnaires, and structured observations. The results showed that the public services offered in our study environment did not meet users’ expectations. However, the study identified the fundamental aspects to be considered in providing quality public services connected to user satisfaction, as well as the strengths of digitization in achieving this quality.

Affordability, Accessibility, and Quality of Maternal Health Care Services and Level of Satisfaction of Mothers in Rural Areas in China

Objective:This study aimed to understand the affordability,accessibility,and quality of maternal and child health services for postpartum mothers,and their impact on satisfaction.Methods:The study utilized the Anderson model and revised the Maternal Pregnancy and Perinatal Health Service Questionnaire.A survey was conducted among 289 mothers aged 20–49 in Feicheng City.Results:Regarding accessibility,most respondents(133)reported that travel time to healthcare services exceeded 60 minutes,while 99 respondents indicated a travel time of 16–30 minutes.The issue of affordability was highlighted,with 86.85%of participants perceiving maternal healthcare services as costly,indicating a significant financial burden.More than 50%of respondents were satisfied with two specific dimensions(P<0.05)regarding the quality of maternal healthcare services.Conclusion:The study found that accessibility,affordability,and quality significantly affect mothers’satisfaction with maternal health services.Future research should focus on developing more suitable service pathways for rural mothers.

Application and Satisfaction Analysis of Humanized Quality Nursing Intervention in the Care of Patients with Critical Respiratory Failure

Objective:To implement humanized quality care in critical respiratory failure nursing,observe the effect,and analyze the satisfaction.Methods:80 patients with severe respiratory failure were divided into 40 cases per group(admitted from February 2022 to December 2023)by double-blind method,the control group performed routine care,and the observation group was given humanized quality care.Results:After the nursing care,two respiratory function indexes of the observation group were lower than those of the control group,and two pulmonary function indexes were higher than those of the control group(P<0.05);regarding the complication situation,the incidence rate of the observation group was lower(P<0.05);regarding the nursing care satisfaction situation,the observation group had a higher level of total satisfaction(P<0.05).Conclusion:The application of a humanized quality nursing intervention model in the care of critical respiratory failure can actively improve patients’respiratory status and lung function,reduce complications,and satisfy patients.

Exploring the Relationship between Quality of Sleep and Learning Satisfactions on the Nursing College Students

Background and Aim: Quality of sleep is essential element for learning and memory. Students’ learning performance may be affected by sleep. The purpose of this study was to explore the relationship between quality of sleep and learning satisfaction on nursing college students. Design and Participants: A cross-sectional with correlation study design was employed. 200 students were recruited from the nursing college. Pittsburgh Sleep Quality Index and Learning Satisfaction Scale were used for data collection. SPSS for window 17.0 was used for data analysis. Results: Findings showed: 1) 53% of participants rated their sleep quality as poor;2) the global learning satisfaction of participants varied between highly satisfaction and satisfaction;3) the global learning satisfaction was significantly negative related to “subjective sleep quality”, “use the sleep pill”, and “daytime dysfunction” (p < 0.05), finally, students who were interested in nursing can be explained 10.2% of the total amount of variances in learning satisfaction. Conclusions: The findings can provide information regarding nursing students’ sleep status and learning satisfaction to school teacher. The information would be helpful as evidences when laying out nursing curriculum to strengthen students’ sleep hygiene and learning of affective domain in the future.

Diabetes Management, Quality of Life and Treatment Satisfaction in Adult Population in Jordan and Lebanon, Observations from the SIMPLIFY Study

Introduction: Type 2 Diabetes Mellitus (T2DM) has witnessed a rise in its prevalence worldwide and in the Middle East region. The overall burden associated with the disease is well characterized, but little is known about patient satisfaction in the region. The purpose of the study is to evaluate the quality of life (QoL) and treatment satisfaction of patients T2DM. Methods: The SIMPLIFY study was an observational, cross-sectional, multicenter, regional study that used patient-reported outcomes of T2DM patients in Jordan and Lebanon. Results: Patients were more satisfied when they were treated exclusively with oral medications, mainly metformin alone or combined with either sulfonylurea or dipeptidyl peptidase-4 inhibitor. Targets for glycated hemoglobin (HbA1c) values were better reached in patients treated with oral medications. Occurrence of comorbidities did not seem to be affected by oral or injectable medications or to affect patients’ satisfaction. Data highlighted a suboptimal screening for albuminuria and showed that most patients were overweight or obese and around 30% suffered from hypoglycemia episodes. Conclusion: Data shed the light on the management of T2DM in Jordan and Lebanon and suggested the need for a more comprehensive approach to T2DM management and selection of medications that would support weight control and a lower hypoglycemia incidence.

Research on Optimal Delivery Days and Customer Satisfaction Based on Quality Costs

Customer satisfaction is an important index to evaluate the competitiveness and efficiency of an enterprise. Every enterprise is confront with the subject of supplying with the customer satisfactory products at the lowest costs and the highest manufacturing speed. Regarding the delivery days of a coach company as a design variable, this paper builds up an optimization model of customer satisfaction, and suggests an effective method to reduce costs and increase customer satisfaction based on analysis and research.

The Relationship Among E-service Quality Dimensions, Overall Internet Banking Service Quality, and Customer Satisfaction in the USA

The purpose of this paper is to examine the relationships of e-service quality dimensions with overall internet banking service quality, and its effect on customer satisfaction in the USA banking industry. The proposed instrument dimensions are identified based on a questionnaire survey conducted in the US. Based on an extensive review of literature, this paper proposed eight dimensions for measuring overall internet banking service quality and its subsequent effect on customer satisfaction. Also, this research uses American internet banking users as survey targets for its empirical studies. The results show significant relationships among the e-service quality dimensions （efficiency, fulfillment, system availability, privacy, assurance/trust, site aesthetics, responsiveness, and contact）, overall internet banking service quality, and customer satisfaction. Little attention has been given in the literature to understanding of the e-service quality dimensions that influence overall internet banking service quality and the specific outcome of customer satisfaction. This paper empirically examines the relationships among the eight e-service quality dimensions, overall internet banking service quality, and customer satisfaction. The findings are important to enable bank managers to have a better understanding of the key e-service quality dimensions of internet banking that affect customer satisfaction. The primary limitations of this study are the scope and size of its sample.

Satisfaction of Patients Operated on and Hospitalized in the Surgery Department of the Referral Health Center of Commune I in the District of Bamako (Resource-Limited Health District)

Introduction: Evaluating the quality of care offered is a reliable indicator of the effectiveness of a health system. Developing countries are still lagging behind in implementing these principles. This work aims to evaluate the satisfaction of patients operated on and hospitalized in the surgery department at the municipality’s reference health center over a period of 6 months (June 2020 to December 2020). Materials and Methods: This is a quantitative, qualitative, transversal and evaluative study over a period of 6 months based on a self-administered questionnaire to patients who underwent surgery and were hospitalized in the surgery department of the reference health center of commune I upon leaving their hospitalization. The questions are structured around welcome, respect and privacy, care, accommodation conditions as well as overall satisfaction. Results: The survey included 260 patients, 60.8% of whom were male. The 31 - 40 year old age group was in the majority and the majority had completed primary education (42.3%). Married patients were the majority, i.e. 60.4% of cases. Patients were not insured in 66.5% of cases. Almost all of the patients surveyed found that the welcome, care, waiting time, respect and privacy were satisfactory. On the other hand, patients found the rooms and beds uncomfortable. Conclusion: The satisfaction survey reveals worrying data regarding the comfort of patients who must challenge caregivers in healthcare structures. Decision-makers should find useful information there to improve the quality of care.

Relationship of Job Satisfaction with Perceived Organizational Support and Quality of Care among Saudi Nurses

Background: Both, job satisfaction with quality of provided health care is considered the main issue which directly influences the health care field because if nurses do not give the quality care to their patients then the patient dissatisfaction increased. Job satisfaction is defined as the extent of workers’ contentedness with their job, either they like the job or individual aspects or facets of jobs, such as type of work or regulation. Objective: To assess nurses’ job satisfaction and perceived organizational support with their effect on quality of provided health care in Saudi Arabia. Methods: Nurses in Saudi Arabia governmental hospitals during the period from 1st March to 30th April 2020 were invited and consecutively included. Data were collected using online questionnaire. Results: The study included 355 nurses with their ages ranged from 25 to 55 years old. Females were 216 (60.8%) of the total participants. Exact of 267 (75.2%) nurses reported that they like the type of work they do, 245 (69%) provided with satisfactory equipment to accomplish my task. There was a significant relation between organizational support and job satisfaction with their effect on quality of care. Conclusion: Organizational support positively affected nonsatisfaction which in turn positively affected quality of delivered care.

The level of patients’ satisfaction and perception on quality of nursing services in the Renal unit, Kenyatta National Hospital Nairobi, Kenya

Introduction: Renal failure is on the increase and patients have to identify with renal services and centres where services for renal replacement therapies are rendered. This calls for health care workers to offer services that are perceived as quality and satisfying in order to meet the biophysical and psychological needs of the patients. Study design: This was a descriptive cross-sectional study undertaken at the Renal unit of Kenyatta National Hospital (KNH). Purpose: The study aimed at determining the level of satisfaction and perception of the quality of nursing services in the Renal unit. Methodology: The study population included all patients who were seeking dialysis services during one month period of data collection. The sample size was 151 following data collection. Data collection tools consisted of semi-structured questionnaires which were administered with the aid of research assistants as well as checklists which were self administered. Data analysis and results: Analysis of data was performed using the statistical package of social sciences (SPSS) version 16. Results of data analysis were presented in form of descriptive statistics which included mean, standard deviation and percentages. Regression analysis, t-test and ANOVA were conducted to determine demographic predictors of patient satisfaction with the nursing services. The results of the study revealed that patients in the Renal unit were generally satisfied with the nursing services. The aggregate mean score for all patients on Likert scale was 71.2 out of 105, with a standard deviation of 16.8. Level of satisfaction was 67.8%. The findings also showed that there was no association between demographic characteristics with the levels of satisfaction with the nursing services. Recommendation: The hospital should keep the patients’ level of satisfaction high and maintain it through the provision of more dialysis machines and hiring more nurses.

Expectations and Level of Satisfaction of the Patient with Parkinson’s Disease Undergoing Deep Brain Stimulation Surgery at the National Institute of Neurology and Neurosurgery

Background: Deep brain stimulation (DBS) is an established treatment for patients with advanced Parkinson’s disease (PD). Reports show continued patient satisfaction after surgery despite not maintaining clinical improvement as measured by evolution scales. Objectives: The present study sought to explore expectations and level of satisfaction in patients after DBS surgery with a semi-structured questionnaire and subsequent correlation with functional scales, Quality of Life (QoL), and motor and non-motor symptoms. Methods: We performed descriptive statistics to represent demographic data, Wilcoxon rank tests to determine significant differences, and Spearman correlation between the applied scales. Results: We evaluated 20 patients with a history of DBS surgery. 45% were female, with a mean age of 55.7 ± 14.15 years, a mean disease duration of 13.42 ± 8.3 years, and a mean time after surgery of 3.18 ± 1.86 years. Patients reported surgery meeting expectations in 85.5% and continued satisfaction in 92%. These two variables showed a significant correlation. Conclusions: This sample of patients remained satisfied after DBS surgery, although we found no differences in motor and non-motor clinimetric scales. Further studies are needed to confirm the importance of assessing quality of life in patients with DBS.

How Do People Understand Urban Air Pollution? Exploring Citizens’ Perception on Air Quality, Its Causes and Impacts in Colombian Cities

Similarly to other Latin American countries, urban air quality is a major concern in Colombia. The purpose of the present study was to explore citizens’ perception on local air pollution, its causes and impacts. A questionnaire was individually applied to a sample of 994 participants. Relationships between demographic features and the perception on air quality were analyzed using a logistic regression, its odds ratio (OR), and a Chi-square test. Eighty percent of the respondents perceive their local air quality as either bad or fair, 65% recognize particulate matter as the main local air pollutant, and 90% recognize negative impacts on people’s health as the main consequence of air pollution. In contrast to other studies where age and economic status are variables highly related with public perception on the level of atmospheric pollution, in this study only the size of the cities has a statistically significant relationship with the perception on local air quality regarding the level of pollution(OR ≥ 1, confidence intervals > 1 and p-values < 0.05). While area sources such as mining and infrastructure construction are identified as the main sources of pollutant emissions in small towns (less than 50,000 inhabitants), in big cities, road traffic is identified as the main source contributor to atmospheric pollution. Opposite to data from official reports, and regardless of the size of the city, households are perceived as the place with greatest contribution to personal air pollution exposure. Results show that citizens are aware of the state of air quality and its health impact is a major concern. Such findings suggest people’s opinions can be used as provisional indicators in cities without data, as well as to monitor the results of local air quality management. As a complementary process, or at the same level of importance given to technical-based policy, citizen participation can contribute to a collective construction of urban air pollution control strategies.

Glycaemic control, treatment satisfaction and quality of life in type 2 diabetes patients in Greece: The PANORAMA study Greek results

AIM: To provide an update on glycaemic control inEuropean patients with type 2 diabetes mellitus(T2DM). We present the Greek population data of the study. METHODS: An observational multicenter, cross-sectional study evaluating glycaemic control and a range of other clinical and biological measures as well as quality of life(Qo L) and treatment satisfaction in 375 patients with T2 DM enrolled by 25 primary care sites from Greece. RESULTS: The mean age of the patients was 63.5 years and the male/female ratio 48.9%/51.1%. 79.7% of the patients exerted none or light physical activity, 82.4% were overweight or obese and 32.9% did not meet Hb A1 c target of less than 7.0%(53 mmol/mol). Patients reported high satisfaction to continue with treatment, high satisfaction with administered treatment and increased willingness to recommend treatment to others(mean Diabetes Treatment Satisfaction Questionnaire score 29.1 ± 5.6). However, 80% of the patients reported that their Qo L would be better without diabetes. Finally, the most challenging parameter reported was the lack of freedom to eat and drink. CONCLUSION: This analysis of the Greek Panorama study results showed that a considerable percentage of T2 DM patients in Greece do not achieve glycaemic target levels, despite the favourably reported patient satisfaction from administered therapy. Additionally, the majority of primary care T2 DM patients in Greece depict the negative effect of the disease in their Qo L.

Midwives’ Professional Satisfaction and the Quality of Obstetric Care in Developing Country

Introduction: In Africa, poor working conditions affect the motivation of health care providers. The objective is to study midwives’ professional satisfaction on the technical quality of emergency obstetric care in Senegal. Material and Methods: This was a prospective study of 16 hospitals in Senegal. The job satisfaction of midwives was measured during a personal interview. The instrument used was validated in Senegal and Mali. Other data collected relate to professional and institutional characteristics. A treatment observation grid was used to measure the quality of obstetric care in labour wards. Mixed-model linear regression was used to estimate the effect of satisfaction on the quality of obstetric care. Results: A total of 65 midwives were interviewed and 325 patients observed. The average quality score was 8.7 ± 1.7. The satisfaction scores ranged from 42.2 ± 17.4 (salary) to 76.7 ± 12.1 (morale satisfaction). A positive and significant correlation was found between quality of care and management (cc = 0.56), remuneration (cc = 0.40), task (cc = 0.32), workload (cc = 0.24) and training (cc = 0.29). The linear mixed model shows that salary (β = 0.40), continuing education (β = 0.17) and management style (β = 0.42) improved the quality of care. Association between moral satisfaction and quality care was negative (β = ﹣0.53). Conclusion: The satisfaction of health professionals is a major determinant of the quality of obstetric care. Its inclusion in the fight against mortality has become imperative in developing.

The Effect of Public Healthcare Service Quality on Residents’ Satisfaction in the United Arab Emirates (UAE), the Case of Ajman Emirate

The quality of healthcare services is becoming a major concern in all countries, through improving performance to maximize the population health, effectively and efficiently, by doing the right thing, at the right time, in the right way, for the right person and having the best possible results, through well-managed hospitals and clinics. The purpose of this paper is to identify and measure Ajman residents’ satisfaction on healthcare service, using data of a sample of 1035 households, randomly selected from a total of 95,531 households, who were permanently residing in the Emirate of Ajman and having prior experience in availing any healthcare service. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 22 and AMOS version 22. Structural Equation Modeling (SEM) analysis showed an acceptable model fit used to measure residents’ satisfaction. Findings showed that in the government sector only reliability and empathy correlated positively with healthcare service quality, which also had a strong, positive correlation with residents’ satisfaction, while tangible, assurance and responsiveness were not sufficiently correlated to healthcare service quality. On the other hand, for private sector, except for responsiveness and tangible dimensions, reliability, assurance, and empathy correlated positively with healthcare service quality, which also had a strong, positive correlation with residents’ satisfaction. This study used healthcare service quality dimensions, namely, tangible, reliability, responsiveness, assurance, and empathy, to determine the residents’ satisfaction within the public hospitals and to provide an empirical contribution to understanding the factors associated with public satisfaction and healthcare systems. According to the survey results, Ajman residents were satisfied 82% on Quality Dimension, 77% on Empathy Dimension, 80% on both Assurance and responsiveness Dimensions, 89% on Reliability Dimension and 88% on Tangible Dimension. Moreover, Statistical analysis revealed that, each of Tangible Dimension, Healthcare Service Quality Dimension and Empathy Dimension, is positively correlated with Healthcare Service Quality. Likewise, Healthcare Service Quality, is also positively correlated with residents’ satisfaction. But Reliability, Responsiveness, and Assurance Dimensions, are not positively correlated with Healthcare Service Quality.

Patient Satisfaction Index and Quality of Life Measurement with Breast-Q after Breast Reconstruction in a Plastic Surgery Center in Mexico

Introduction: Cancer is one of the most devastating pathologies to affect the breast. Mastectomy stigmas are associated with depression, body image dysmorphia, and decreasing quality of life. BREAST-Q is a PROM (Patient Reported Outcome Measures) that has proven useful in measuring satisfaction with breast reconstruction results from the patient’s point of view. Objectives: To measure the satisfaction index and improvement in quality of life after breast reconstruction for breast cancer sequelae in our hospital in the last 5 years. Materials and Methods: Descriptive Study that includes patients with Breast cancer diagnosis that underwent mastectomy and breast reconstruction (prosthesis or autologous tissue) in “Hospital Central Sur de Petroleos Mexicanos” (January 2015 to January 2020), whose satisfaction index was measured with BREAST-Q one year after reconstruction. Results: 153 patients were included in the analysis. Mean global satisfaction was 74 points. We observed a tendency towards higher psychosocial, sexual and appearance satisfaction in patients who underwent reconstruction with autologous tissue. The mean satisfaction with provided information was 64 points and with the medical team > 90 points. Conclusion: Breast reconstruction is associated to a high satisfaction index and quality of life improvement regardless of the technique. BREAST-Q proved to be useful in evaluating patient experience and it helped us identify areas of opportunity to improve our care.

Client Satisfaction and Quality of Life at Primary Healthcare Clinics and Psychiatric Hospitals in the Eastern Province of Saudi Arabia

Over the past few years, greater attention has been paid to the importance of incorporating behavioral health treatment into primary health care (PHC) settings in the Kingdom of Saudi Arabia (KSA). The purpose of the present study was to compare the participants’ satisfaction on psychological services and quality of life (QOL) among primary healthcare clinics, psychiatric hospitals and healthy controls. The Arabic version of the World Health Organization Quality of Life-short version (WHOQOL-Bref) and Client Satisfaction Questionnaire (CSQ) were administered to 36 PHC participants, 60 hospital participants, and 63 healthy controls. In all QOL domains, there was no significant difference obtained on participants’ QOL between PHC and hospital settings. Except for similar score to PHC participants on overall QOL (OQOL), healthy controls scored higher than the other two groups on four QOL domains and General Health (GH) facet. As for clients’ satisfaction, participants under PHC setting reported significantly higher satisfaction compared to hospitals and healthy controls. Hospital participants reported higher client care satisfaction than healthy controls. Improvement in the quality of mental health care such as ease of referrals and detection of undiagnosed mental health conditions could be the cause for higher satisfaction with PHC services. Stigma associated with mental illness creates serious barriers to Saudi patient’s access to psychiatric clinics of large hospitals. There is a need for incorporating qualified mental health providers into PHC and educating the general public to become aware of certain beliefs and attitudes that limit access to treatment and prospects for recovery of persons with mental illnesses.

Public satisfaction with the quality of First Health Facility Services in Indonesia: Does sociodemographic matter?

Objective:To investigate individual characteristics related to satisfaction with the quality of First Health Facility Services(FHFS)in Indonesia.Methods:This cross-sectional study analyzes national representation data.Meanwhile,the study involved 9846 representative respondents in 2019.Respondent’s satisfaction with FHFS based on the five dimensions of service quality(SERVQUAL)is a dependent variable.Independent variables consist of sex,marital status,age,education,employment,insurance ownership,and economics.The study used multivariate logistic regression to explain the relationship between individual characteristics and FSHS quality.Results:77.3%Respondents were satisfied with FHFS,with the highest order of satisfaction dimensions being assurance(59.4%),empathy(57.3%),reliability(53.6%),responsiveness(52.7%),and then tangibility(49.1%).Multivariate logistic analysis showed that divorce was 1.48 more likely than never-married to be satisfied(95%CI 1.17-1.87).Employees were 0.77 less likely than the unemployed to get satisfied(95%CI 0.70-0.86).Respondents with higher education was 0.82 less likely than those with primary education to be satisfied(95%CI 0.67-0.99).Meanwhile,respondents who had government-run insurance were 1.61 more likely than uninsured to be satisfied(95%CI 1.42-1.80).Moreover,the rich were 0.82 less likely than the poor to get satisfied(95%CI 0.73-0.92).Conclusions:Community satisfaction with FHFS is generally high,though some areas could be improved.Demographic factors are still strongly related to satisfaction ratings.The government can assess the quality of services in accordance with standards and disseminate information about service standards for primary facilities to all levels of society,ensuring that service satisfaction is rated as good by all groups.