Understanding the meaning of satisfaction with treatment outcome.

OBJECTIVE Although satisfying patients is an important goal in health care, what is meant by satisfaction in relation to treatment outcome is not clear. The objective of this study was to explore patients' perspectives on the meaning of satisfaction with treatment outcome. DESIGN We conducted a qualitative exploratory study. SETTING This study was conducted at an adult tertiary care hospital. PATIENTS Individuals who had undergone elective hand surgery were included in this study. INTERVENTION In-depth, open-ended interviews in which 31 participants described their experience of a hand condition, how they evaluated the outcome of surgical interventions, and what it meant to be satisfied or dissatisfied with these outcomes were examined. ANALYSIS : Interview transcripts were analyzed using Gadow's conceptualization of embodiment states: "object body" (disunity between the affected hand and the self) or "cultivated immediacy" (harmony between the hand and the self). RESULTS Eight of 9 dissatisfied individuals were categorized as "object body" and 15 of 19 satisfied individuals were in, or in transition to, "cultivated immediacy". These states fluctuated and were also dependent on context (eg, social setting) and time since surgery. CONCLUSION In relation to the outcome of hand surgery, satisfaction was experienced as a relative lack of tension between the patient's sense of self and the affected hand (ie, satisfaction was having a hand that could be lived with unself-consciously). Emotional and social effects of interventions and the influence of context should be considered in future measures of satisfaction with treatment outcome. Finally, interventions directed toward facilitating patients' experience of body-self unity could promote satisfaction with treatment outcome.