Patient satisfaction and quality of recovery.

Abstract

We agree with Royse and Clarke that patient satisfaction and quality of recovery are based on different constructs and are different outcomes 1. However, does that mean that there is no ‘way’ of looking for a potential relationship between each, as the authors of the editorial claim? It is much more likely that the opposite is true, which makes sense; it would be interesting to know if there is a supplementary influence of quality of recovery on overall patient satisfaction with care, taking into account several dimensions of quality of care. To extend the authors’ metaphor of different fruits, we are interested to know whether the addition of new fruit varieties (quality of recovery) to the fruit drink (overall patient satisfaction) changes the taste of the fruit drink. Our result showed that this was not the case: the tastes of the ‘new’ fruits were already present in the existing drink (care/nursing), and the known ingredients of the existing fruit drink (information and communication) are mainly responsible for its flavour, judged by the drinker/patient. We disagree with their statement that measuring patient satisfaction is not useful in the context of patient-centred outcome quality. Can patient satisfaction really be seen as a ‘non-patient-centred’ outcome quality, or is satisfaction the most important subjective factor of patient-centred care 2, 3? Conceptually, even though patient satisfaction is perhaps more difficult to define than quality of recovery, aspects of the concept, such as information, communication, respect and patient care, are known to be among the most important factors of care for patients 3-5. As mentioned in our article, a limitation of our study was that the satisfaction questionnaire used in our study was not entirely validated, as it was only a multi-item, and not a multi-dimensional, developed instrument 6. We agree with the authors that our conclusion should have been stated more precisely by saying that quality of recovery – measured with the QoR-15 scale – has only a marginal supplementary effect on patient satisfaction using a composite satisfaction scale.