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Social desirability in the measuring of patient satisfaction after treatment of coloproctologic disorders

On shortcomings of general bipolar satisfaction scales for quality management

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Abstract

Background and aims

Within the field of medicine, much attention is being paid to quality management, whereby patient satisfaction plays a major role. In order to measure this construct, usually rather general, bipolar rating scales are applied. However, these scales are often susceptible to social desirability biases.

Patients–methods

Coloproctological patients were asked to complete a questionnaire with ratings of satisfaction and anxiety at two different points of measurement: One group while in treatment (N = 86) and a second group approximately 1 year after their treatment (N = 328).

Results

Even when controlling for relevant demographic influences, a clear decrease in intensity of the evaluation ratings is shown when the survey was administered 1 year after release from hospital as compared to during the patients’ stay in hospital. For generally formulated scales of patient satisfaction, social desirability constitutes a significant bias.

Conclusion

The usual conceptualization of a bipolar continuum of patient satisfaction or dissatisfaction must be renounced. Instead, questionnaires might be constructed in three steps which investigate problem dimensions at a medium level of concreteness. Only in this way can quality management gain credibility and trust within as well as beyond the field of medicine.

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References

  1. Coyle J, Williams B (1999) Seeing the wood for the trees: defining the forgotten concept of patient dissatisfaction in the light of patient satisfaction research. Leadersh Health Serv 12:i–ix

    CAS  Google Scholar 

  2. Dozier AM, Harriet JK, Ingersoll GL, Homberg S, Schultz AW (2001) Development of an instrument to measure patient perception of the quality of nursing care. Res Nurs Health 24:506–517

    Article  PubMed  CAS  Google Scholar 

  3. Sitzia J, Wood N (1997) Patient satisfaction: a review of issues and concepts. Soc Sci Med 45:1829–1843

    Article  PubMed  CAS  Google Scholar 

  4. William B, Coyle J, Healy D (1998) The meaning of patient satisfaction: an explanation of high reported levels. Soc Sci Med 47:1351–1359

    Article  Google Scholar 

  5. Dubé L, Bélanger M-C, Trudeau E (1996) The role of emotions in health care satisfaction. J Health Care Mark 16:45–51

    PubMed  Google Scholar 

  6. Hall J, Dornan M (1988) Meta-analysis of satisfaction with medical care: description of research domain and analysis of overall satisfaction levels. Soc Sci Med 27:637–644

    Article  PubMed  CAS  Google Scholar 

  7. Hall J, Dornan M (1990) Patient sociodemographic characteristics as predictors of satisfaction with medical care: a meta-analysis. Soc Sci Med 30:811–818

    Article  PubMed  CAS  Google Scholar 

  8. Hildebrandt H, Nickel S, Trojan A (1999) Planung, Methodik und Durchführung der DAK-Patientenbefragung. (Survey of DAK patients: planning, method, and procedure). In: Schupeta E, Hildebrandt H (eds) Patientenzufriedenheit messen und steigern (Measuring and increasing patient satisfaction). Asgard, Sankt Augustin, pp 56–81

    Google Scholar 

  9. Calnan M (1988) Towards a conceptual framework of lay evaluation of health care. Soc Sci Med 27:927–933

    Article  PubMed  CAS  Google Scholar 

  10. Tucker JL (2002) The moderators of patient satisfaction. J Manag Med 16:48–66

    Article  PubMed  Google Scholar 

  11. Stump T, Dexter P, Tierney W, Wolinsky FD (1995) Measuring patient satisfaction with physicians among older and diseased adults in a primary care municipal outpatient setting: an examination of three instruments. Med Care 33:958–972

    Article  PubMed  CAS  Google Scholar 

  12. Health Services Research Group (1992) A guide to direct measures of patient satisfaction in clinical practice. Can Med Assoc J 46:1727–1731

    Google Scholar 

  13. Harpole L, Orav J, Hickey M, Posther K, Brennan TA (1995) Patient satisfaction in the ambulatory setting: influence of data collection methods and sociodemographic factors. J Gen Intern Med 11:431–434

    Article  Google Scholar 

  14. Fitzpatrick R (1991) Survey of patient satisfaction: I—important general considerations. BMJ 302:887–889

    Article  PubMed  CAS  Google Scholar 

  15. Paulhus DL (2002) Socially desirable responding: the evolution of a construct. In: Braun HI, Jackson DN (eds) The role of constructs in psychological and educational measurement. Erlbaum, Mahwah, pp 49–69

    Google Scholar 

  16. Edwards C, Staniszweska S, Crichton N (2004) Investigation of the ways in which patients’ reports of their satisfaction with healthcare are constructed. Sociol Health Illn 26:159–183

    Article  PubMed  Google Scholar 

  17. Currie V, Harvey G, West E, McKenna H, Keeney S (2005) Relationship between quality of care, staffing levels, skill mix and nurse autonomy: literature review. J Adv Nurs 51:73–82

    Article  PubMed  Google Scholar 

  18. Edwards C, Staniszewska S (2000) Accessing the user’s perspective. Health Soc Care Commun 8:417–424

    Article  Google Scholar 

  19. Ross M, Buehler R (1994) Creative remembering. In: Neisser U, Fivush R (eds) The remembering self: construction and accuracy in the self-narrative. Cambridge University Press, New York, pp 205–235

    Google Scholar 

  20. Rubin DC (1996) Remembering our past. Cambridge University Press, New York

    Google Scholar 

  21. Schacter DL (1995) Memory distortions: how minds, brains, and societies reconstruct the past. Harvard University Press, Cambridge

    Google Scholar 

  22. Lohaus A, Schmitt GM (1989) Fragebogen zur Erhebung von Kontrollüberzeugungen zu Krankheit und Gesundheit (KKG). Handanweisung (Questionnaire for the assessment of control beliefs regarding illness and health). Hogrefe, Göttingen

    Google Scholar 

  23. Fisher RJ, Katz JE (2000) Social-desirability bias and the validity of self-reported values. Psychol Market 17:105–120

    Article  Google Scholar 

  24. Schmidt C, Möller J, Reibe F, Güntert B, Kremer B (2003) Patientenzufriedenheit in der stationären Versorgung: Stellenwert, Methoden und Besonderheiten (Patient’s satisfaction with their care in hospital: its ranking, methods and special features). Dtsch Med Wochenschr 128:619–624

    Article  PubMed  CAS  Google Scholar 

  25. Kerlinger FN (1964) Foundations of behavioral research. Holt, Rinehart and Winston, New York

    Google Scholar 

  26. Cohen J (1988) Statistical power analysis for the behavioral sciences, 2nd edn. Erlbaum, Hillsdale

    Google Scholar 

  27. Turris SA (2005) Unpacking the concept of patient satisfaction: a feminist analysis. J Adv Nurs 50:293–298

    Article  PubMed  Google Scholar 

  28. Hyrkäs K, Paunonen M (2000) Patient satisfaction and research-related problems (part 2). Is triangulation the answer? J Nurs Manag 8:237–245

    Article  PubMed  Google Scholar 

  29. Schneider H, Palmer N (2002) Getting to the truth? Researching user views of primary health care. Health Policy Plan 17:32–41

    Article  PubMed  Google Scholar 

  30. Staniszweska S, Henderson L (2005) Patients’ evaluations of the quality of care: influencing factors and the importance of engagement. J Adv Nurs 49:530–537

    Article  Google Scholar 

  31. Flanagan JC (1954) The critical incident technique. Psychol Bull 51:327–358

    Article  PubMed  CAS  Google Scholar 

  32. Byrne M (2001) Critical incident technique as a qualitative research method. AORN J 74:536–539

    Article  PubMed  CAS  Google Scholar 

  33. Dunn WR, Hamilton DD (1986) The critical incident technique—a brief guide. Med Teach 8:207–215

    Article  PubMed  CAS  Google Scholar 

  34. Dachelet CZ, Wemett MF, Garling EJ, Craig-Kuhn K, Kent N, Kitzman HJ (1981) The critical incident technique applied to the evaluation of the clinical practicum setting. J Nurs Educ 20:15–31

    PubMed  CAS  Google Scholar 

  35. Newble DI (1983) The critical incident technique: a new approach to the assessment of clinical performance. Med Educ 17:401–403

    Article  PubMed  CAS  Google Scholar 

  36. Kamppainen JK (2000) The critical incident technique and nursing care quality research. J Adv Nurs 32:1264–1271

    Article  Google Scholar 

  37. Krippendorff K (1980) Content analysis: an introduction to its methodology. Sage, Thousand Oaks

    Google Scholar 

  38. Neuendorf KA (2001) The content analysis guidebook. Sage, Thousand Oaks

    Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Coloproctology, Hospital St. Josef, Saarbrücken, Germany

    Gerald D. Giebel

  2. Department of Psychology, University of Cologne, Herbert-Lewin-Str. 2, 50931, Cologne, Germany

    Norbert Groeben

Authors
  1. Gerald D. Giebel
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  2. Norbert Groeben
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Corresponding author

Correspondence to Norbert Groeben.

Appendix: sample of items

Appendix: sample of items

  1. 1.

    Causes of anxiety: My anxiety was caused primarily by the fact that

    1. (a)

      I did not know what to expect

    2. (b)

      I was worried about the severity of my illness...

  2. 2.

    Reasons for reduction of anxiety: My anxiety was reduced by

    1. (a)

      the friendly admission

    2. (b)

      conversation with the nurses...

  3. 3.

    Peak of anxiety: My anxiety was at its highest

    1. (a)

      during the admission

    2. (b)

      after the briefing before the operation...

  4. 4.

    Postoperative worries: After the operation, my greatest concern was

    1. (a)

      the removal of swabs and drainages

    2. (b)

      whether I would receive a sufficient amount of pain killers...

  5. 5.

    Possibilities of reducing anxiety: It would have considerably helped me to reduce my anxiety if

    1. (a)

      I had received a brochure with information, which I could have read in peace

    2. (b)

      the conversations with the physicians had been more detailed...

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Giebel, G.D., Groeben, N. Social desirability in the measuring of patient satisfaction after treatment of coloproctologic disorders. Langenbecks Arch Surg 393, 513–520 (2008). https://doi.org/10.1007/s00423-008-0310-x

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  • DOI: https://doi.org/10.1007/s00423-008-0310-x

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