RESEARCH TO PRACTICE
Resident and Family Satisfaction Surveys:
Use Discrepancy QuestionsSimmons, S. F. & Ouslander, J. G. (2005). Resident and family satisfaction with incontinence and mobility care: Sensitivity to intervention effects? The Gerontologist 45, 3, 318-326.
“This study evaluated whether the satisfaction levels of long-term-care residents and their family members concerning incontinence and mobility care were sensitive to an improvement intervention.” Researchers addressed the following questions:
1. What are residents’ and family members’ satisfaction with and preferences for incontinence (toileting assistance) and mobility (walking assistance) care frequencies?
2. Are residents’ reports sensitive to care improvements based on direct satisfaction questions or discrepancy indices?
3. Are family members’ reports sensitive to care improvements based on direct satisfaction questions or discrepancy indices?
4. What are the implications of the results for measuring residents’ and family members’ satisfaction with care quality improvements?The researchers found that only the discrepancy questions, those that reflect the difference between perceived and preferred support, registered a change in residents’ responses that reflected the improvement in services. An example of discrepancy questioning might ask “How many times a day would you like someone to assist you with walking?” followed with “How many time during the day does someone on staff walk with you?”
Often satisfaction surveys ask, “Are you satisfied with how often someone on the staff helps you to walk?” When questions like this were asked the answers did not change even when the services in question were enhanced. Simmons also found acquiescence bias where residents give the answer they think you want instead of their own views.
In response to satisfaction questions to family members, the study found that family reports were not as sensitive as residents’ reports to care improvement. The speculation is that family members do not think they have enough knowledge of the services. However both residents and family members seem to give more sensitive answers concerning care to open ended questions.
Implications: Most nursing homes use satisfactions surveys to measure how well culture change initiatives are progressing – particularly to key into areas that may need more attention. It is well to note that not all satisfaction surveys will give the information needed to have a full picture. Hopefully the side issues in this study will help homes develop satisfaction surveys that will provide meaningful information.