Factors associated with patient satisfaction.

PURPOSE: This investigation tested the null hypothesis that psychological factors have no effect on patient satisfaction in a hand and upper limb practice.

METHODS: The Center for Epidemiologic Studies Depression Scale, the Pain Catastrophizing Scale, and the Disabilities of the Arm, Shoulder, and Hand questionnaire were administered to 248 new patients presenting to a hand and upper limb practice. After the appointment, the treating physician was asked to rate the patient's uneasiness with his or her symptoms. The Consumer Assessment of Health Care Providers and Systems questionnaire was mailed to patients 2 weeks after their visit. A total of 178 patients returned this questionnaire.

RESULTS: There were small but significant correlations between (1) depression and perception of how well the doctor (a) listens carefully, (b) gives easy-to-understand instructions, and (c) spends enough time; (2) pain catastrophizing and the degree to which doctor gives enough information about a procedure; and (3) the doctor's perception of inordinate patient concern and (a) the impression that the doctor gives easy-to-understand explanations, (b) the impression that the doctor listens carefully, (c) the impression that the doctor gives enough information about surgical procedures, and (d) the patient's overall rating of the doctor. In multivariable models, the doctor's perception of disproportionate uneasiness was the only significant predictor of "doctor gave enough information" and "doctor listened carefully."

CONCLUSIONS: In this study, the provider's sense that the patient was disproportionately uneasy with his or her symptoms was the only significant predictor of patient satisfaction, and this accounted for a small percentage of the variance in responses to these items. Patient satisfaction is complex, and the divide between medical advice and a patient's expectations are not easily reduced to one or more disease-specific or patient-specific factors.