Lessons from research with older people for measuring patient and service user satisfaction

Much effort is expended in recording satisfaction with health and social care services, but such satisfaction measures do not always take theory into account. A simple model of satisfaction assumes that it is the result of a discrepancy between expectations and experience, but an examination of the cognitive processes involved reveals a much more complex story. In this paper, a theoretical model of the satisfaction process is first presented, followed by an examination of qualitative data on satisfaction. Participants in a study of satisfaction with social care services, where the majority were older people, were asked to rate their satisfaction level and describe their experiences in detail in a semi-structured interview. Data were analysed thematically. The results showed that some participants gave the same satisfaction rating despite having very different experiences. This was shown to be a result of variation in the understanding of the rating scale categories, basing their judgement on different domains of the social care experience, or temporal issues. The presentation concludes with recommendations for future measurement of satisfaction, relevant to both health and social care services