Satisfaction With Health Care: A Predictor of Hemodialysis Patient Compliance.

Abstract

Several studies in general medical populations have demonstrated the positive relation between satisfaction with health care and compliance with treatment recommendations. Overall, the compliance literature suggests that the behavior of the health care provider can influence patient compliance and the resulting health outcome. However, the relation between patient satisfaction and compliance with the hemodialysis regimen has not been examined. Because of this populations' frequent and extensive interaction with the dialysis staff, exploration of the effects of satisfaction with these relationships and the care provided on patient compliance appears to be an important health care issue. This study evaluated the ability of a micro (MHPSS) and macro (SCQ) measure of satisfaction to predict subsequent compliance in 209 hemodialysis patients. It was hypothesized that patient satisfaction would be predictive of subsequent compliance with the hemodialysis regimen. It was also hypothesized that a micro measure of hemodialysis patient satisfaction (MHPSS) which addresses satisfaction with specific aspects of patient care would be a better predictor of compliance than a macro measure which addresses overall satisfaction with patient care. The third hypothesis was that satisfaction with those disciplines most active in each area of compliance would be predictive of that area of compliance. Significant results between satisfaction and compliance were found primarily for fluid gain and attendance. Satisfaction with the disciplines most active in assessing or modifying these behaviors was related to compliance. Contrary to prediction, subjects who were more satisfied had higher fluid gains between sessions. The results suggest that the micro and macro satisfaction measure total scores are essentially equivalent in predicting compliance. However, the individual subscale scores of the MHPSS (i.e., dietician) accounted for the most variance in fluid gain.