Can patient satisfaction with decisions predict compliance with surgery?
BACKGROUND
Patient satisfaction with treatment decisions is a discrete and measurable component of the satisfaction paradigm, distinct from satisfaction with health care services.


OBJECTIVE
The study goal was to determine if the Satisfaction With Decision (SWD) scale, a valid and reliable 6-item survey, can predict patient compliance with surgery proposed by their otolaryngologist.


METHODS
Prospective study using the SWD scale plus measures of office visit satisfaction, provider satisfaction, and disease-specific quality of life.


METHODS
Metropolitan, private nonprofit hospital.


METHODS
The study population consisted of 151 patients scheduled for surgery, with a median age of 5.8 years and an age range of 0.6 to 65.3 years.


METHODS
At the time surgery was scheduled, the decision-maker completed a 12-item questionnaire about satisfaction and quality of life that included the SWD scale. Noncompliant patients were contacted, and the specific reason for cancellation was ascertained.


RESULTS
The strongest predictor of surgical cancellation was the SWD survey score, with a median value of 4.8 for patients completing surgery compared with 3.8 for those who cancelled (P < 0.001). Patients with scores <4.0 had a 57% cancellation rate, whereas those with scores > or =4.0 had a 98% completion rate. Patients were also more likely to cancel if it was their first visit with the surgeon (P = 0.004) or if they were responsible for their own decisions (P = 0.007). Cancellations were not associated with office visit satisfaction, patient quality of life, or demographic characteristics of the decision-maker.


CONCLUSIONS
Patients who are satisfied with their initial decision to undergo surgery are most likely to comply with planned therapy. Conversely, patients who score <4.0 on the SWD scale may benefit from additional preoperative counseling to increase the likelihood of compliance.
Parhiscar
Afshin
A
Department of Otolaryngology, SUNY Health Science Center at Brooklyn and The Long Island College Hospital, NY 11201, USA.
Rosenfeld
Richard M
RM
D000328:Adult; D002648:Child; D002675:Child, Preschool; D003376:Counseling; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D009819:Office Visits; D013517:Otorhinolaryngologic Surgical Procedures; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011446:Prospective Studies; D011788:Quality of Life; D012017:Referral and Consultation; D011795:Surveys and Questionnaires