Testing a New Theory of Patient Satisfaction with Treatment Outcome

Objectives: Theories of patient satisfaction with treatment outcome have not been developed and tested in healthcare settings. The objectives of this study were to test a new theory linking patient satisfaction and embodiment (body-self unity) and examine it in relation to other competing theories. Design: We conducted a prospective cohort study. Setting: This study was conducted at a tertiary care hospital. Patients: We studied 122 individuals undergoing elective hand surgery. Methods: Satisfaction with treatment outcome approximately 4 months after surgery was examined against the following factors (representing 7 theories of satisfaction): 1) overall clinical outcome, 2) patients' a priori self-selected important clinical outcomes, 3) foresight expectations, 4) hindsight expectations, 5) psychologic state, 6) psychologic state in those with poor outcomes, and 7) embodiment. Analysis: Seven hypotheses were tested first using univariate analyses and then multivariable regression analysis. Results: Satisfaction with treatment outcome was significantly associated with embodiment. Three confounders-the extent to which surgery successfully addressed patients' most important reason for surgery, hindsight expectations, and workers' compensation-were also significant. The final model explained 84% of the variance in a multidimensional measure of satisfaction with treatment outcome. Conclusion: This research suggests that satisfaction with treatment outcome could be facilitated by developing strategies to improve body-self unity, and eliciting and addressing the patient's most important reason for undergoing treatment.