[Methodologic difficulties in measuring patient satisfaction--discrepancy coming from formulating questions].
Reports concerning methodology of studies on patients' satisfaction suggest that the way questions are composed may have significant effect on the received answers. For example responses to closed-ended questions are usually positive, while in contrast, the responses to open-ended questions tend to be negative. This is described as "leniency effect". The aim of the present study was to compare the difference in patients' answers to open and closed questions in a survey on patients' satisfaction with family doctor services. The study was carried out in two general practices in Białystok, Poland and participants were randomly chosen from the patients' lists of their physicians. The survey was conducted by the technique of mailed questionnaire. Of the total 1000 questionnaires sent out, 579 were filled in and returned, and 560 were eligible for further analysis. The results show the discrepancy between the rating given by patients in a five-grade scale and their own answers to open questions. Among 216 individuals grading family doctor's care as fairly good in an answer to a closed question, 42 persons (19.4%) used phrases expressing negative feelings in an answer to an open question asking for justification of their opinion. Most frequently negative comments were related to short time of consultation, difficulty with obtaining referral to a specialist and lack of holistic approach to a patient. The results of our study suggest that questionnaires are not sufficiently precise tools in a complex evaluation of doctors' care by their patients. In practice this may mean that questionnaire surveys, which are often used because of the ease of administration, may require to be complemented or replaced by other more qualitative research tools, such as in depth interviews and open questions.
Zakładu Medycyny Rodzinnej i Pielegniarstwa Srodowiskowego Akademii Medycznej w Białymstoku. marcinek@amb.edu.pl
Ludmiła
L
Marcinowicz
Agnieszka
A
Borzuchowska
Ryszard
R
Grebowski
D000328:Adult; D002983:Clinical Competence; D005194:Family Practice / Q000592:standards*; D005260:Female; D019538:Health Care Surveys / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011044:Poland; D011320:Primary Health Care / Q000592:standards*; D011785:Quality Assurance, Health Care; D012017:Referral and Consultation / Q000592:standards*; D011795:Surveys and Questionnaires / Q000592:standards*; D013997:Time Factors