Beyond the ceiling effect: Using a mixed methods approach to measure patient satisfaction

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Journal Article
International Journal of Multiple Research Approaches, 2011, 5 (1), pp. 52 - 63
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This study reports patient satisfaction with the nursing care on a neurosurgical critical care unit. A modified version of the Ludwig-Beymer Patient Satisfaction Questionnaire (PSQ-7) was used, and included structured items and semi-structured interview questions. Data were collected from 149 patients. Participants rated their satisfaction as high (Mean = 25.14; SD = 2.96). The distribution of scores was skewed and every item demonstrated a ceiling effect. Principal component analysis yielded a one-component solution which explained 48% of the variance. NVivo® was used to match PSQ-7 scores with qualitative data. Participantsâ comments were categorised as positive, negative or âyes, butâ. Just over half the patients made positive comments and 29% of patients in the low group made negative comments. Three categories: âcommunicationâ, ânursing care deliveryâ and âthe hospital environmentâ emerged from the qualitative data. A mixed method approach enables researchers to move beyond the ceiling effect of quantitative measures of patient satisfaction and to gain a more meaningful explanation of patient satisfaction.
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