What do people with aphasia think about their health care? Factors influencing satisfaction and dissatisfaction

Abstract

Background: Patient experience and satisfaction play an integral role in driving and directing quality improvement in health care. Although there is an increasing body of literature examining patient satisfaction with health care—including that of stroke patients—few studies have sought to capture the views of patients with aphasia. As a result, the experiences and opinions of people with aphasia on this subject remain unheard. In order to evaluate and improve health care for people with aphasia, there is a need to explore their experiences and resulting levels of satisfaction or dissatisfaction with their health care.

Aims: This study aimed to explore the factors influencing the satisfaction and dissatisfaction of people with aphasia with regards to their health care.

Methods & Procedures: A qualitative, descriptive phenomenological research approach was used. Semi-structured in-depth interviews with 50 participants with aphasia were analysed using qualitative content analysis to identify both categories and themes of health-care satisfaction.

Outcomes & Results: Seven categories (areas of care) were identified as influencing participant satisfaction and dissatisfaction: (1) Forming Relationships; (2) Manner and Methods of Service Delivery; (3) Information, Communication and Knowledge; (4) Structure and Relevance of Therapy; (5) Organisational Management; (6) Individual Support; and (7) Positivity and Improvement. In addition, three core themes (described as Information and Communication, Dignity and Respect, and Control and Independence) and two secondary themes (Trust and Support and Understanding) were identified as being overarching areas of influence, appearing across the seven areas of care.

Conclusions: This study has identified specific factors and values contributing to the satisfaction and dissatisfaction of people with aphasia with their health care. The findings may enable health providers to better understand the needs of people with aphasia and to implement appropriate improvements to health care and service delivery.

Keywords:

• Aphasia
• Patient satisfaction
• Health-care outcomes
• Stroke.

Acknowledgments

Data collection was funded by NHMRC Grant ID 401532 awarded to L. Worrall, B. Davidson, D. Hersh D and A. Ferguson. We thank all of the participants with aphasia who shared their experiences. We also acknowledge the contribution of all those involved in the data collection, transcription and editing process, particularly to Tami Howe, Deborah Hersh, Susan Sherratt and Sarah Wallace.