Williams B, Coyle J, Healy D
Department of Epidemiology and Public Health, Ninewells Hospital and Medical School, Dundee, UK.
Soc Sci Med. 1998 Nov;47(9):1351-9. doi: 10.1016/s0277-9536(98)00213-5.
The social policy background to the proliferation of patient satisfaction surveys is a desire for increased patient representation and participation. Within this context, it is assumed that satisfaction surveys embody patients' evaluations of services. However, as most surveys report high satisfaction levels, the interpretation of satisfaction as the outcome of an active evaluation has been called into question. The aim of this study is to identify whether and how service users evaluate services. This was made possible through unstructured in-depth interviews with users of mental health services and through more structured discussion around their responses on a patient satisfaction questionnaire (CSQ 18B) whose psychometric properties has been well documented. Twenty-nine people with current or recent contact with mental health services within the British National Health Service were interviewed. The data revealed that service users frequently described their experiences in positive or negative terms. However, the process by which these experiences were transformed into "evaluations" of the service was complex. Consequently, many expressions of "satisfaction" on the CSQ 18B hid a variety of reported negative experiences. An explanation for this lack of correspondence is outlined.
患者满意度调查激增的社会政策背景是希望增加患者的代表性和参与度。在此背景下，人们认为满意度调查体现了患者对服务的评价。然而，由于大多数调查显示满意度很高，将满意度解释为积极评价的结果受到了质疑。本研究的目的是确定服务使用者是否以及如何评价服务。这通过对心理健康服务使用者进行非结构化深度访谈以及围绕他们对一份患者满意度调查问卷（CSQ 18B）的回答进行更结构化的讨论得以实现，该问卷的心理测量特性已有充分记录。对29名在英国国民医疗服务体系中目前或近期接触过心理健康服务的人进行了访谈。数据显示，服务使用者经常用积极或消极的语言描述他们的经历。然而，这些经历转化为对服务“评价”的过程很复杂。因此，CSQ 18B上许多“满意”的表述背后隐藏着各种负面经历。文中概述了这种不一致的一个解释。
