The meaning of patient satisfaction : re-assessing a qualitative psychological research methodology
In a move towards a more informed understanding of the concept of satisfaction, this study aims to explore how thirty dermatology patients describe what it means to be satisfied with their healthcare. This was undertaken by adopting a qualitative research approach, using an in-depth semi-structured interview methodology. It was conducted within the context of a randomised controlled trial of telemedicine in dermatology (RCT). A secondary aim was to evaluate the extent to which the methodological approach of the study (interpretative phenomenological analysis) was successful in eliciting such descriptions. The findings reveal patient satisfaction as being a complex and fluid construct underpinned by a range of values, beliefs, attitudes and experiences. Individual participant descriptions of satisfaction emphasise the importance of 1) receiving a diagnosis treatment and cure, 2) minimum waiting time for appointments and treatment 3) the need to receive adequate information and explanations 4) receiving individualised personal care and 5) the need for participants to feel as though they were being taken seriously and 6) the importance of practitioner characteristics/good communication. Perhaps the most significant observation was the sequential nature of satisfaction, which was defined, redefined and re-evaluated by participants throughout the interview process. This study also identified a continuum of satisfaction across patients' definitions of being 'satisfied' as opposed to 'very satisfied' with healthcare. The method of data analysis (interpretative phenomenological analysis-IPA) was a useful approach to guide the analysis identifying and exploring themes relevant to eliciting the meaning of satisfaction. However, limitations to this methodology were apparent over the course of the study, and alternative methodology, contextualised interpretative phenomenological analysis has been postulated. It is suggested that the journey for a definitive notion of patient satisfaction, can only be meaningfully directed by accepting some form of refinement of phenomenological methods as a means of adding sophistication to existing quantitative studies.