Understanding patient satisfaction : the predictive value of quality of life and patient self-selected goals

• Main Author: Saunders, Amy
• Published: University of East London 2010
• Subjects: 150
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.533046

Patient satisfaction is acknowledged as an important outcome measure for aesthetic surgery. However, knowledge of the relationship between psychosocial variables and satisfaction is limited. In the area of bilateral breast reduction (BBR), there has been research showing high satisfaction rates alongside improvements in health-related quality of life (HRQOL) and appearance-related quality of life (ARQOL). Furthermore, in other surgical disciplines, achievement of patient self-selected goals has positively correlated with patient satisfaction. This study, therefore, investigates HRQOL, ARQOL and patient goals in relation to satisfaction following BBR surgery. Data was collected from 49 participants over four time-points; two prior to surgery and two post-surgery. The Short-Form 36 health survey measures HRQOL and the Derriford Appearance Scale 24 measures ARQOL. Patient goals were collected using a semi-structured interview and rated out of 100% for achievement post-BBR. The study adopts a single item measure of postsurgery satisfaction, rated from 0 - 100%. Content analysis of patient goals reveals eight categories. High frequencies of 'pain' goals are noted, but there was no significant difference between the frequency of pain compared to clothes, appearance, activity or emotional goals. Importance ratings suggest equal value is given to all goal categories. This appears to contrast with previous research and the dominant discourses surrounding BBR surgery. Consistent with previous findings, HRQOL and ARQOL are shown to improve significantly at 6 - 8 weeks and 3-4 months post-surgery. Multiple regression analyses suggest a possible role for achievement of patient self-selected goals and post-surgery ARQOL for predicting satisfaction at 6 - 8 weeks post-BBR. Methodological difficulties are acknowledged and thus the conclusions provided are tentative. Provisional implications are suggested for audit, clinical and research purposes.