Objective: To identify factors contributing to elderly stroke patients' satisfaction with rehabilitation following stroke.
Design: Qualitative study using semi-structured interviews.
Setting: Interviews conducted in two phases, once in a stroke rehabilitation unit and once after hospital discharge.
Subjects: Twelve elderly stroke patients (seven women and five men, aged 60—87 years).
Results: One main category: 'To be treated with respect and dignity' was identified as a core factor contributing to patients' satisfaction with the rehabilitation services. This main factor was divided into five subcategories: (1) Being treated with humanity, (2) Being acknowledged as individuals, (3) Having their autonomy respected, (4) Having confidence and trust in professionals, (5) Dialogue and exchange of information. The statements covered a continuum from satisfaction via indifference to dissatisfaction. Expressions of satisfaction emerged mainly as general statements while expressions of dissatisfaction described situations in greater detail. Satisfaction was merely connected to daily care experiences and fulfilment of basic needs. Trust in providers and being dignified seemed more closely associated with satisfaction than being involved in treatment decisions. The findings demonstrate how the quality of patient—professional interaction influences patients' satisfaction with stroke rehabilitation.
Conclusion: To be treated with respect and dignity seems to be a core element influencing vulnerable elderly stroke patients' satisfaction with rehabilitation. A merely functional definition of the success of rehabilitation should be expanded into an approach encompassing patients' perceptions and personal preferences. The meaning of dignity for elderly stroke patients in the rehabilitation setting should be further clarified and given practical substance.
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References
1.
Cleary PD , McNeil BJPatient satisfaction as an indicator of quality care . Inquiry1988; 25: 25-36.
2.
Donabedian A.The quality of care. How can it be assessed?JAMA1988; 260: 1743-48.
3.
Strasser S. , Aharony L. , Greenberger D.The patient satisfaction process: moving toward a comprehensive model . Med Care Rev1993; 50: 219-48.
4.
Kramer AMRehabilitation care and outcomes from the patient's perspective . Med Care1997; 35(6 suppl): JS48-57; discussion JS8-63.
5.
Williams B.Patient satisfaction: a valid concept?Soc Sci Med1994; 38: 509-16.
6.
Crow R. , Gage H. , Hampson S. et al. The measurement of satisfaction with healthcare: implications for practice from a systematic review of the literature . Health Technol Assess2002; 6: 1-244.
7.
Mulcahy L TJ.Pathways, pyramids and icebergs? Mapping the links between dissatisfaction and complaints . Sociol Health Illn1998; 20: 825-47.
8.
Fitzpatrick R. , Hopkins A.Problems in the conceptual framework of patient satisfaction research: an empirical exploration . Sociol Health Illn1983; 5: 297-311.
9.
Pascoe GCPatient satisfaction in primary health care: a literature review and analysis . Eval Program Plann1983; 6: 185-210.
10.
Glass TA , Maddox GLThe quality and quantity of social support: stroke recovery as psycho-social transition . Soc Sci Med1992; 34: 1249-61.
11.
Clark MS , Smith DSPsychological correlates of outcome following rehabilitation from stroke . Clin Rehabil1999; 13: 129-40.
12.
McKevitt C. , Redfern J. , Mold F. et al. Qualitative studies of stroke: a systematic review . Stroke2004; 35: 1499-505.
13.
Lui MH , MacKenzie AEChinese elderly patients' perceptions of their rehabilitation needs following a stroke . J Adv Nurs1999; 30: 391-400.
14.
Owens DJ , Batchelor C.Patient satisfaction and the elderly . Soc Sci Med1996; 42: 1483-91.
15.
O'Mahony PG , Rodgers H. , Thomson RG , Dobson R. , James OFSatisfaction with information and advice received by stroke patients . Clin Rehabil1997; 11: 68-72.
16.
Aharony L. , Strasser S.Patient satisfaction: what we know about and what we still need to explore . Med Care Rev1993; 50: 49-79.
17.
Engedal K. , Haugen P. , Gilje K. , Laake P.Efficacy of short mental tests in the detection of mental impairment in old age . Compr Gerontol1988; 2: 87-93.
18.
Mahoney FI , Barthel DWFunctional evaluation: the Barthel Index . Md State Med J1965; 14: 61-65.
19.
Malterud K.Shared understanding of the qualitative research process. Guidelines for the medical researcher . Fam Pract1993; 10: 201-206.
20.
Giorgi A.Sketch of a psychological phenomenological method. In Giorgi A. ed. Phenomenology and psychological research. Duquesne University Press , 1985, 8-22.
21.
Joffe S. , Manocchia M. , Weeks JC , Cleary PDWhat do patients value in their hospital care? An empirical perspective on autonomy centred bioethics . J Med Ethics2003 ; 29: 103-108.
22.
Strull WM , Lo B. , Charles G.Do patients want to participate in medical decision making?JAMA1984; 252: 2990-94.
23.
Lewinter M. , Mikkelsen S.Patients' experience of rehabilitation after stroke . Disabil Rehabil1995; 17: 3-9.
24.
Wellwood I. , Dennis M. , Warlow C.Patients' and carers' satisfaction with acute stroke management . Age Ageing1995 Nov; 24: 519-24.
25.
Pound P. , Bury M. , Gompertz P. , Ebrahim S.Stroke patients' views on their admission to hospital . BMJ1995; 311: 18-22.
26.
Macduff CNStroke patients' perceptions of hospital nursing care . J Clin Nurs1998; 7: 442-50.
27.
Pound P. , Gompertz P. , Ebrahim S.Patients' satisfaction with stroke services . Clin Rehabil1994; 8: 7-17.
28.
Anderson R.The aftermath of stroke: the experience of patients and families. Cambridge University Press , 1992.
29.
Scholte op Reimer WJ , de Haan RJ , Limburg M. , van den Bos GAPatients' satisfaction with care after stroke: relation with characteristics of patients and care . Qual Health Care1996; 5: 144-50.
30.
Clark MS , Smith DSFactors contributing to patient satisfaction with rehabilitation following stroke . Int J Rehabil Res1998; 21: 143-54.
31.
Boter H. , De Haan RJ , Rinkel GJClinimetric evaluation of a Satisfaction-with-Stroke-Care questionnaire . J Neurol2003; 250: 534-41.
32.
Sitzia J. , Wood N.Patient satisfaction: a review of issues and concepts . Soc Sci Med1997; 45: 1829-43.
33.
Pleschberger S.Dignity and the challenge of dying in nursing homes: the residents' view . Age Ageing2007 ; 36: 197-202.
34.
Seedhouse D. , Gallagher A.Undignifying institutions . J Med Ethics2002; 28: 368-72.
