title: A pilot mixed methods study of patient satisfaction with chiropractic care for back pain.
abstract: OBJECTIVE
  Patient satisfaction is important to payers, clinicians, and patients. The concept of satisfaction is multifactorial and measurement is challenging. Our objective was to explore the use of a mixed-methods design to examine patient satisfaction with chiropractic care for low back pain.
  
  
  METHODS
  Patients were treated 3 times per week for 3 weeks. Outcomes were collected at week 3 and week 4. Qualitative interviews were conducted by the treating clinician and a nontreating staff member. Outcome measures were the Roland Morris Back Pain Disability Questionnaire, the visual analog scale for pain, and the Patient Satisfaction Scale. Interviews were recorded and transcribed and analyzed for themes and constructs of satisfaction. We compared qualitative interview data with quantitative outcomes, and qualitative data from 2 different interviewers.
  
  
  RESULTS
  All patients reported high levels of satisfaction. Clinical outcomes were unremarkable with little change noted on visual analog scale and Roland Morris Back Pain Disability Questionnaire scores. We categorized patient comments into the same constructs of satisfaction as those identified for the Patient Satisfaction Scale: Information, Effectiveness, and Caring. An additional construct (Quality of Care) and additional subcategories were identified. Satisfaction with care is not explained by outcome alone. The qualitative data collected from 2 different interviewers had few differences.
  
  
  CONCLUSIONS
  The results of this study suggest that it is feasible to use a mixed-methods design to examine patient satisfaction. We were able to refine data collection and analysis procedures for the outcome measures and qualitative interview data. We identified limitations and offer recommendations for the next step: the implementation of a larger study.
authors.affiliation: Palmer College of Chiropractic, Davenport, Iowa 52803, USA. robert.rowell@palmer.edu
authors.forename: Robert M
authors.initials: RM
authors.lastname: Rowell
authors.forename: Judith
authors.initials: J
authors.lastname: Polipnick
mesh_terms: D000328:Adult; D000368:Aged; D002684:Chiropractic / Q000379:methods / Q000523:psychology* / Q000592:standards; D003625:Data Collection; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010353:Patient Education as Topic; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D010865:Pilot Projects; D036301:Qualitative Research; D011787:Quality of Health Care; D012107:Research Design; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome