{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T20:44:53Z","timestamp":1790801093554,"version":"4.1.0"},"reference-count":22,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T00:00:00Z","timestamp":1762819200000},"content-version":"unspecified","delay-in-days":133,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["bmjph"],"accepted":{"date-parts":[[2025,10,10]]},"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Patient satisfaction is an aspect of healthcare systems, impacting both mental and physical health outcomes. People experiencing anxiety and depression significantly contribute to patient satisfaction complexity, affecting evaluations of healthcare services. Understanding these challenges is essential for tailored care. By examining these dynamics, we aim to enhance healthcare services to meet diverse patient needs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study investigated the relationship between chronic illness, mental health and patient satisfaction in hospital environments. The cross-sectional design included 678 patients with chronic illnesses from Damascus hospitals. We used a meticulously designed paper questionnaire, incorporating reliable measures Patient Health Questionnaire (PHQ) and Satisfaction with the Assessment of Patient Satisfaction (SAPS). Trained interviewers conducted face-to-face interviews, ensuring confidentiality and ethical compliance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In our investigation of 663 participants, we found diverse age distribution and balanced body mass index. Simple linear regression revealed that depression levels significantly contributed to increased anxiety. PHQ-Anxiety (PHQ-A) explained 41.6% of PHQ-Depression variance. Additionally, heightened depression levels were associated with decreased satisfaction (SAPS). Education level impacted anxiety, with those without a secondary certificate exhibiting higher PHQ-A levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Anxiety and depression emerged as key factors influencing patient evaluations of healthcare services. By recognising these complexities, healthcare providers can tailor their services to better meet the diverse needs of patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjph-2024-001822","type":"journal-article","created":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T12:55:18Z","timestamp":1763038518000},"page":"e001822","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Association between mental health status and patient satisfaction: a cross-sectional study in three Damascus hospitals, Syria"],"prefix":"10.1136","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-7455-5991","authenticated-orcid":false,"given":"Rawan","family":"Daboul","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Homs University, Homs, Syrian Arab Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MHD Ghazi","family":"Aboulkher","sequence":"additional","affiliation":[{"name":"Damascus University Faculty of Medicine, Damascus, Syrian Arab Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4848-6719","authenticated-orcid":false,"given":"Jamal","family":"Ataya","sequence":"additional","affiliation":[{"name":"University of Aleppo Faculty of Medicine, Damascus, Syrian Arab Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2946-6820","authenticated-orcid":false,"given":"Mohammad","family":"Hamdi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology - Head and Neck Surgery, Al-Mouwasat University Hospital, Damascus, Syrian Arab Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rustum","family":"Mackieh","sequence":"additional","affiliation":[{"name":"Damascus University Faculty of Medicine, Damascus, Syrian Arab Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,11,13]]},"reference":[{"key":"2026010703073980000_3.2.e001822.1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aef277"},{"key":"2026010703073980000_3.2.e001822.2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.psy.47.4.312"},{"key":"2026010703073980000_3.2.e001822.3","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph110908743"},{"key":"2026010703073980000_3.2.e001822.4","doi-asserted-by":"crossref","DOI":"10.1186\/s12888-017-1381-4","article-title":"Common adult psychiatric disorders in Swedish primary care where most mental health patients are treated","volume":"17","author":"Sundquist","year":"2017","journal-title":"BMC Psychiatry"},{"key":"2026010703073980000_3.2.e001822.5","doi-asserted-by":"publisher","DOI":"10.1157\/13086324"},{"key":"2026010703073980000_3.2.e001822.6","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1002\/da.22152","article-title":"Patient-reported outcomes of quality of life, functioning, and depressive symptom severity in major depressive disorder comorbid with panic disorder before and after SSRI treatment in the star*d trial","volume":"31","author":"IsHak","year":"2014","journal-title":"Depress Anxiety"},{"key":"2026010703073980000_3.2.e001822.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.apnr.2021.151488"},{"key":"2026010703073980000_3.2.e001822.8","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0272057","article-title":"Strategies to improve patient loyalty and medication adherence in Syrian healthcare setting: The mediating role of patient satisfaction","volume":"17","author":"AlOmari","year":"2022","journal-title":"PLoS ONE"},{"key":"2026010703073980000_3.2.e001822.9","doi-asserted-by":"publisher","DOI":"10.1176\/appi.psy.50.6.613"},{"key":"2026010703073980000_3.2.e001822.10","article-title":"Measuring Patient Satisfaction and Factors Affecting it in the General Surgery Setting in Jeddah","volume":"11","author":"Almehman","year":"2019","journal-title":"Cureus"},{"key":"2026010703073980000_3.2.e001822.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2013.12.010"},{"key":"2026010703073980000_3.2.e001822.12","doi-asserted-by":"publisher","DOI":"10.1682\/JRRD.2006.06.0061"},{"key":"2026010703073980000_3.2.e001822.13","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.healthpol.2008.04.012","article-title":"Relationship between anxiety level of patients and their satisfaction with different aspects of healthcare","volume":"89","author":"Herrera-Espi\u00f1eira","year":"2009","journal-title":"Health Policy"},{"key":"2026010703073980000_3.2.e001822.14","doi-asserted-by":"crossref","DOI":"10.3390\/healthcare11243130","article-title":"A Scoping Review of Adult Inpatient Satisfaction with Mental Health Services","volume":"11","author":"Elgendy","year":"2023","journal-title":"Healthcare (Basel)"},{"key":"2026010703073980000_3.2.e001822.15","first-page":"201","article-title":"Forensic and civil psychiatric inpatients: development of the inpatient satisfaction questionnaire","volume":"37","author":"Shiva","year":"2009","journal-title":"J Am Acad Psychiatry Law"},{"key":"2026010703073980000_3.2.e001822.16","doi-asserted-by":"crossref","DOI":"10.1186\/1472-6963-8-103","article-title":"Treatment needs and acknowledgement of illness - 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