Patient Satisfaction: The Concept
A. Fountouki
Nursing Department, International Hellenic University, Thessaloniki, Greece.
D. Theofanidis
*
Nursing Department, International Hellenic University, Thessaloniki, Greece.
*Author to whom correspondence should be addressed.
Abstract
Despite exhaustive research in health, and related fields, patient satisfaction remains a quite ambiguous concept. As yet, no single method for measuring patient satisfaction has been accepted as a ‘golden global standard’. Furthermore, various techniques employed range from indirect measures focusing on beliefs, attitudes and expectations to direct satisfaction/dissatisfaction ratings on various scales and mixed measures. As generally admitted by scholars, the greatest difficulty hinges on the fact that patient satisfaction is a concept and therefore not amenable to direct observation. This implies the necessity of an indicator which is defined as an observable variable assumed to point to, or estimates some other usually unobservable variable. It has been further suggested that the choice of the particulars in an indicator should be justified by the specification of the theoretical link between the indicators and indicated. The purpose of this Commentary/Opinion Article is to elaborate on the concept of patient satisfaction and the current state of the literature concerning the conceptualization of this concept to therefore inform and possibly guide future research in this field for health care professionals and social scientists alike. A health care event comprises of several aspects and attributes. Thus, if patient satisfaction studies are to be more useful they need to produce global and overall measures of satisfaction as well as specific information on characteristic components of a service. Although there are a number of both generic and specific measures for assessing patient satisfaction, nevertheless, these usually provide a partial insight into the real experience of patients and therefore should not be used alone and exclusively to guide the implementation of future health policies. The use of surveys in patients' satisfaction measurements, providing that appropriate and specific questions are asked, has been advocated by many scholars. Yet, others argue that patient satisfaction questionnaires do not access an independent phenomenon but actively construct to it, as respondents are forced to express themselves in alien terms. Thus, due to their rigid format, questionnaires can be very leading and limiting, for example by focusing attention on aspects the researcher thinks is important and therefore limiting the responses. That is, answers are only as good as the questions asked. Therefore, if only specific questions are asked, one may miss out on what people really think is important. Overall, a better understanding of patient satisfaction calls for a more intense theoretical and methodological input rather than a further increase of the global, overwhelming accumulation of healthcare statistics. Here, as elsewhere, data without insights are often sterile and sometimes even misleading.
Keywords: Patient satisfaction, dissatisfaction, quality, healthcare, surveys