A review of patient satisfaction with musculoskeletal physical therapy
Assessing patients’ satisfaction is of utmost importance, but lacks definitive research
In today’s evolving health care landscape, there’s been an increasing focus on patient-centered care, now considered the leading school of thought in delivering health services. Following this shift, patient satisfaction has grown to become an important indicator of the quality of care, a factor that’s even more significant since satisfied patients are more likely to adhere to treatment, benefit from health care and have a higher quality of life. While a number of studies have evaluated patient satisfaction recently, none have pooled all available literature on the topic to develop clear conclusions. Therefore, a systematic review was conducted using studies on patients who received outpatient physical therapy musculoskeletal care to determine satisfaction levels.
Small but sufficient number of studies makes cut
Major databases were searched for pertinent literature on patient satisfaction and potential fits were screened using strict inclusion criteria. The search produced 3,790 studies, of which 15 met the inclusion criteria (nine cross-sectional patient surveys, three qualitative studies, two clinical trials and one longitudinal cohort study). Data pertaining to patient satisfaction was then extracted from each study, and the risk of bias was independently evaluated depending on the type of study. All studies used either a Likert scale or similar questionnaire to rate satisfaction, thus assuring good focus on outcomes.
Patients are predominantly satisfied with physical therapy treatment
Assessment of quantitative data showed patient satisfaction to be consistently high, with a pooled estimate of 4.44 on a scale of 1-5, where 1 is “very dissatisfied” and 5 is “very satisfied.” Further analysis pointed out a higher level of satisfaction in patients with acute musculoskeletal conditions than chronic ones, and two trials found greater satisfaction for back pain patients with exercise therapy compared to manual therapy, massage or electrotherapies. A notable quantitative data finding was that patients were more satisfied with treatment delivered by PTs compared to general medical practitioners, mainly due to the explanations given by PTs. Qualitative data found therapist characteristics as well as the process and organization of care to be associated with higher patient satisfaction, while treatment outcomes and expectations were surprisingly not major indicators. Across all studies, the most consistent determinant of patient satisfaction was the therapist’s attributes, especially regarding skill, knowledge, professionalism, friendly attitude and effective communication. Process of care (duration and frequency of treatment, having the same therapist regularly), and organization of care (friendly staff, easy accessibility) were the next respective predictors for satisfaction, but weren’t as strong as PT attributes. Shockingly, weakest of all predictors were treatment outcomes and expectations, which goes to show that patients can be satisfied even if they don’t have the most ideal outcomes, so long as they’re treated and cared for properly. These positive findings on patient satisfaction should be carefully consulted by PTs and implementations should be made based on the valuable information they provide.
-Summarized by Greg Gargiulo
-As reported in the Jan. ’11 edition of Physical Therapy
