Hays R D, Ware J E
Med Care. 1986 Jun;24(6):519-24. doi: 10.1097/00005650-198606000-00006.
It is well-documented that ratings of medical care received personally (personal referent) yield more favorable responses than ratings of care received by people in general (general referent). Hence general items are useful in achieving greater variation in responses to satisfaction surveys. However, the validity of general items relative to personal items is being debated currently. It has been hypothesized that bias due to socially desirable response set (SDRS) would be greatest for items with a personal referent. To test this hypothesis, the authors compared both kinds of satisfaction ratings for adults (N = 3,918) who scored high and low on SDRS during Rand's Health Insurance Experiment. Across sites and years of the experiment, the rating item with a personal referent was consistently biased upward for those manifesting SDRS. The rating item with a general referent was not. Further, the correlation between SDRS and the difference between ratings on the personal and general referent items was statistically significant, suggesting that more favorable ratings of medical care received personally compared with ratings of care received by people in general are in part due to SDRS bias. Results are discussed in terms of implications for constructing a valid satisfaction survey.
有充分记录表明，对个人所接受医疗服务的评分（个人参照）比总体人群所接受医疗服务的评分（一般参照）能产生更积极的回应。因此，一般项目有助于在满意度调查中获得更大的回应差异。然而，目前对于一般项目相对于个人项目的有效性存在争议。有人假设，由于社会期望反应定势（SDRS）导致的偏差在具有个人参照的项目中最为明显。为了验证这一假设，作者比较了兰德健康保险实验中SDRS得分高低不同的成年人（N = 3918）的这两种满意度评分。在整个实验的不同地点和年份中，对于表现出SDRS的人来说，具有个人参照的评分项目始终存在向上的偏差。而具有一般参照的评分项目则不存在这种情况。此外，SDRS与个人和一般参照项目评分之间的差异的相关性具有统计学意义，这表明与总体人群所接受医疗服务的评分相比，对个人所接受医疗服务给予更积极评分部分是由于SDRS偏差。文章从对构建有效满意度调查的影响方面对结果进行了讨论。
