Abstract
Research has not yet fully investigated links to consultation duration, patient expectations, satisfaction, and enablement in nurse practitioner consultations. This study was developed to address some of these research gaps in nurse practitioner consultations, particularly with a focus on expectations, satisfaction, and enablement. To explore the influence of pre-consultation expectations, and consultation time length durations on patient satisfaction and enablement in nurse practitioner consultations in primary health care. Survey component of a larger convergent parallel mixed methods case study designed to conjointly investigate the communication processes, social interactions, and measured outcomes of nurse practitioner consultations. The survey element of the case study focusses on investigating patients' pre-consultation expectations and post-consultation patient satisfaction and enablement. A questionnaire measuring pre-consultation expectations, and post-consultation satisfaction and enablement, completed by a convenience sample of 71 adults consulting with nurse practitioners at a general practice clinic. Initial fieldwork took place in September 2011 to November 2012, with subsequent follow-up fieldwork in October 2016. Respondents were highly satisfied with their consultations and expressed significantly higher levels of enablement than have been seen in previous studies of enablement with other types of clinicians (P=0.003). A significant, small to moderate, positive correlation of 0.427 (P=0.005) between general satisfaction and enablement was noted. No significant correlation was seen between consultation time lengths and satisfaction or enablement. Higher levels of patient enablement and satisfaction are not necessarily determined by the time lengths of consultations, and how consultations are conducted may be more important than their time lengths for optimising patient satisfaction and enablement.
Highlights
Patients’ evaluative perceptions of their clinical consultations have been analysed in research of communication in clinical consultations via three main areas of enquiry: expectations, satisfaction, and enablement
Satisfaction and enablement data was collected in the survey component of the case study using two previously validated questionnaires: the ‘Nurse Practitioner Satisfaction Survey’ (NPSS), which has been developed in North America for measuring patient satisfaction with nurse practitioner delivered primary care (Agosta, 2009a); and a frequently used measure of patient enablement, developed in the United Kingdom, called the ‘Patient Enablement Instrument’ (PEI), which is intended to capture patients’ feelings of confidence, ability and, coping after a general practice consultation (McKinley, 2004)
It would be beneficial to repeat the survey used in this case study with a larger, more varied sample of respondents who see nurse practitioners for general practice care, so that the findings of this study in relation to high satisfaction and enablement scores, and comparisons with consultation time lengths, can either be further supported or modified
Summary
Patients’ evaluative perceptions of their clinical consultations have been analysed in research of communication in clinical consultations via three main areas of enquiry: expectations, satisfaction, and enablement. It has been speculated that patients’ lowered expectations of consulting with nurse practitioners may affect patients’ subsequent evaluations of consultations via outcome measures, such as satisfaction, though this relationship has not yet been fully examined (Horrocks et al, 2002; Redsell et al, 2007b). It is appropriate to further examine patients’ expectations and evaluative perceptions of consulting with nurse practitioners, and to determine the relationship between patients’ expectations, satisfaction, and enablement It has frequently been noted in North American studies of nurse practitioner consultations that many patients report high levels of satisfaction after consulting with a nurse practitioner (Knudston, 2000: Pinkerton and Bush, 2000; Agosta, 2009a; 2009b). It is important to investigate patient satisfaction with nurse practitioner primary health care consultations in the United Kingdom with an instrument devised for measuring satisfaction in those types of consultations
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