Factors Associated With Patient Satisfaction Measured Using a Guttman-Type Scale
Patient experience measures such as satisfaction are increasingly tracked and incentivized. Satisfaction questionnaires have notable ceiling effects that may limit learning and improvement. This study tested a Guttman-type (iterative) Satisfaction Scale (GSS) after a musculoskeletal specialty care v...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2020-12-01
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| Series: | Journal of Patient Experience |
| Online Access: | https://doi.org/10.1177/2374373520948444 |
| _version_ | 1818047596262850560 |
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| author | Yvonne Versluijs MD Laura E Brown PhD Mauna Rao Amanda I Gonzalez MD Matthew D Driscoll MD David Ring MD, PhD |
| author_facet | Yvonne Versluijs MD Laura E Brown PhD Mauna Rao Amanda I Gonzalez MD Matthew D Driscoll MD David Ring MD, PhD |
| author_sort | Yvonne Versluijs MD |
| collection | DOAJ |
| description | Patient experience measures such as satisfaction are increasingly tracked and incentivized. Satisfaction questionnaires have notable ceiling effects that may limit learning and improvement. This study tested a Guttman-type (iterative) Satisfaction Scale (GSS) after a musculoskeletal specialty care visit in the hope that it might reduce the ceiling effect. We measured floor effects, ceiling effects, skewness, and kurtosis of GSS. We also assessed factors independently associated with GSS and the top 2 possible scores. In this cross-sectional study, 164 patients seeing an orthopedic surgeon completed questionnaires measuring (1) a demographics, (2) symptoms of depression, (3) catastrophic thinking in response to nociception, (4) heightened illness concerns, and (5) satisfaction with the visit (GSS). Bivariate and multivariable analyses sought associations of the explanatory variable with total GSS and top 2 scores of GSS. Accounting for potential confounding using multivariable analysis, lower satisfaction was independently associated with greater symptoms of depression (β: −0.03; 95% CI: −0.05 to −0.00; P = .047). The top 2 scores of the GSS were independently associated with women (compared to men: odds ratio [OR]: 2.12, 99% CI: 1.01-4.45, P = .046) and lower level of education (masters’ degree compared to high school; OR: 0.16, 95% CI: 004-0.61, P = .007). The GSS had no floor effect, a ceiling effect of 38%, a skewness of −0.08, and a kurtosis of 1.3. The 38% ceiling effect of the iterative (Guttman-style) satisfaction measure is lower than ordinal satisfaction scales, but still undesirably high. Alternative approaches for reducing the ceiling effect of patient experience measures are needed. |
| first_indexed | 2024-12-10T10:08:18Z |
| format | Article |
| id | doaj.art-a376fed7e2734136bf848048dbe56bcc |
| institution | Directory Open Access Journal |
| issn | 2374-3735 2374-3743 |
| language | English |
| last_indexed | 2024-12-10T10:08:18Z |
| publishDate | 2020-12-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Patient Experience |
| spelling | doaj.art-a376fed7e2734136bf848048dbe56bcc2022-12-22T01:53:11ZengSAGE PublishingJournal of Patient Experience2374-37352374-37432020-12-01710.1177/2374373520948444Factors Associated With Patient Satisfaction Measured Using a Guttman-Type ScaleYvonne Versluijs MD0Laura E Brown PhD1Mauna Rao2Amanda I Gonzalez MD3Matthew D Driscoll MD4David Ring MD, PhD5 Department of Trauma Surgery, Leiden University Medical Center, Leiden, the Netherlands Department of Trauma Surgery, Leiden University Medical Center, Leiden, the Netherlands Department of Surgery and Perioperative Care, Dell Medical School—The University of Texas at Austin, Austin, TX, USA Department of Surgery and Perioperative Care, Dell Medical School—The University of Texas at Austin, Austin, TX, USA Department of Surgery and Perioperative Care, Dell Medical School—The University of Texas at Austin, Austin, TX, USA Department of Surgery and Perioperative Care, Dell Medical School—The University of Texas at Austin, Austin, TX, USAPatient experience measures such as satisfaction are increasingly tracked and incentivized. Satisfaction questionnaires have notable ceiling effects that may limit learning and improvement. This study tested a Guttman-type (iterative) Satisfaction Scale (GSS) after a musculoskeletal specialty care visit in the hope that it might reduce the ceiling effect. We measured floor effects, ceiling effects, skewness, and kurtosis of GSS. We also assessed factors independently associated with GSS and the top 2 possible scores. In this cross-sectional study, 164 patients seeing an orthopedic surgeon completed questionnaires measuring (1) a demographics, (2) symptoms of depression, (3) catastrophic thinking in response to nociception, (4) heightened illness concerns, and (5) satisfaction with the visit (GSS). Bivariate and multivariable analyses sought associations of the explanatory variable with total GSS and top 2 scores of GSS. Accounting for potential confounding using multivariable analysis, lower satisfaction was independently associated with greater symptoms of depression (β: −0.03; 95% CI: −0.05 to −0.00; P = .047). The top 2 scores of the GSS were independently associated with women (compared to men: odds ratio [OR]: 2.12, 99% CI: 1.01-4.45, P = .046) and lower level of education (masters’ degree compared to high school; OR: 0.16, 95% CI: 004-0.61, P = .007). The GSS had no floor effect, a ceiling effect of 38%, a skewness of −0.08, and a kurtosis of 1.3. The 38% ceiling effect of the iterative (Guttman-style) satisfaction measure is lower than ordinal satisfaction scales, but still undesirably high. Alternative approaches for reducing the ceiling effect of patient experience measures are needed.https://doi.org/10.1177/2374373520948444 |
| spellingShingle | Yvonne Versluijs MD Laura E Brown PhD Mauna Rao Amanda I Gonzalez MD Matthew D Driscoll MD David Ring MD, PhD Factors Associated With Patient Satisfaction Measured Using a Guttman-Type Scale Journal of Patient Experience |
| title | Factors Associated With Patient Satisfaction Measured Using a Guttman-Type Scale |
| title_full | Factors Associated With Patient Satisfaction Measured Using a Guttman-Type Scale |
| title_fullStr | Factors Associated With Patient Satisfaction Measured Using a Guttman-Type Scale |
| title_full_unstemmed | Factors Associated With Patient Satisfaction Measured Using a Guttman-Type Scale |
| title_short | Factors Associated With Patient Satisfaction Measured Using a Guttman-Type Scale |
| title_sort | factors associated with patient satisfaction measured using a guttman type scale |
| url | https://doi.org/10.1177/2374373520948444 |
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