Many Factors Are Involved in Measuring Patients’ Satisfaction

BETHESDA, Md--"Patient satisfaction" is one measure used to assess the need for quality improvements in the hospital setting. However, since "satisfaction" is a personal evaluation by the patient of health services or providers, the parameters being measured may vary widely.

Speaking at the 1st International Conference on Research in Palliative Care, Judy Paice, PhD, RN, described factors that relate to individual patient variations in satisfaction and are not necessarily due to the hospital environment.

For instance, studies have shown that elderly persons are more likely to report satisfaction with their care than are younger people. In addition, single marital status, higher number of diagnoses at hospitalization, lower educational level, more severe illness at discharge, and greater psychological distress all correlated with reporting of less satisfaction, said Dr. Paice, professor of nursing and Clinical Nurse Specialist in the Department of Neurosurgery, Rush University Medical Center, Chicago.

Satisfaction With Pain Control

Patients undergoing surgical procedures for pain control who had more severe pain reported higher levels of dissatisfaction with their care than those with less severe pain. "However," she said, "this is confounded by the influence of anxiety, depression, greater cognitive impairment, and lower income level, which also had an effect on postoperative patient reports of satisfaction with their pain management."

Thus, she explained, absolute level of pain does not necessarily correlate with lower satisfaction, as some patients with severe pain still reported higher satisfaction levels with their care.

Measurement of satisfaction with analgesia in cancer pain patients may be influenced by the way the question is asked, she noted. "Were you satisfied with your pain management?" is a broader question than "Were you satisfied with your pain control?" which refers specifically to the patient’s pain relief.

Satisfaction with analgesia may be reported by the same patient differently to different surveyors. For example, she said, patients may be less likely to report dissatisfaction to caregivers who are directly involved in their care, as opposed to an independent inquiry.

Although 50% of patients studied said they experienced more pain than they had expected when initially diagnosed with cancer, 80% reported that they were satisfied with their pain management.

"Satisfaction is a complex measurement," Dr. Paice said. "General questions of overall satisfaction will yield much higher results than questions that address specific aspects of a patient’s care." Small differences in satisfaction may be very meaningful, she said, "particularly when there is a wide discrepancy between the level of analgesia achieved and the level of satisfaction reported for that relief."