title: Social desirability in the measuring of patient satisfaction after treatment of coloproctologic disorders: on shortcomings of general bipolar satisfaction scales for quality management.
abstract: OBJECTIVE
  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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Coloproctology, Hospital St Josef, Saarbrücken, Germany.
authors.forename: Gerald D
authors.initials: GD
authors.lastname: Giebel
authors.forename: Norbert
authors.initials: N
authors.lastname: Groeben
mesh_terms: D000328:Adult; D000368:Aged; D015982:Bias; D003108:Colonic Diseases / Q000601:surgery*; D015179:Colorectal Neoplasms / Q000601:surgery*; D003625:Data Collection / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011594:Psychometrics / Q000706:statistics & numerical data; D012002:Rectal Diseases / Q000601:surgery*; D012928:Social Desirability; D011795:Surveys and Questionnaires