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Can patient satisfaction with decisions predict compliance with surgery?

Authors
Journal
Otolaryngology - Head and Neck Surgery
0194-5998
Publisher
SAGE Publications
Publication Date
Volume
126
Issue
4
Identifiers
DOI: 10.1067/mhn.2002.123445
Disciplines
  • Mathematics
  • Medicine

Abstract

Abstract Background: Patient satisfaction with treatment decisions is a discrete and measurable component of the satisfaction paradigm, distinct from satisfaction with health care services. Objective: The study goal was to determine if the Satisfaction With Decision (SWD) scale, a valid and reliable 6-item survey, can predict patient compliance with surgery proposed by their otolaryngologist. Design: Prospective study using the SWD scale plus measures of office visit satisfaction, provider satisfaction, and disease-specific quality of life. Setting: Metropolitan, private nonprofit hospital. Patients: The study population consisted of 151 patients scheduled for surgery, with a median age of 5.8 years and an age range of 0.6 to 65.3 years. Interventions: At the time surgery was scheduled, the decision-maker completed a 12-item questionnaire about satisfaction and quality of life that included the SWD scale. Noncompliant patients were contacted, and the specific reason for cancellation was ascertained. Results: The strongest predictor of surgical cancellation was the SWD survey score, with a median value of 4.8 for patients completing surgery compared with 3.8 for those who cancelled ( P < 0.001). Patients with scores <4.0 had a 57% cancellation rate, whereas those with scores ≥4.0 had a 98% completion rate. Patients were also more likely to cancel if it was their first visit with the surgeon ( P = 0.004) or if they were responsible for their own decisions ( P = 0.007). Cancellations were not associated with office visit satisfaction, patient quality of life, or demographic characteristics of the decision-maker. Conclusions: Patients who are satisfied with their initial decision to undergo surgery are most likely to comply with planned therapy. Conversely, patients who score <4.0 on the SWD scale may benefit from additional preoperative counseling to increase the likelihood of compliance. (Otolaryngol Head Neck Surg 2002;126:365-70.)

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