Empowering Healthcare Through User Feedback: A Multidimensional Analysis of the Knowledge

Figures & data

Table 1 The Background Characteristics of Service Users Giving Feedback

Background Characteristics	Patients		Significant Others
	n (%)		n (%)
Patients’ gender
Women	361 (73)		50 (48)
Men	135 (27)		54 (52)
Patient’s age (years)
0–10	0 (0)		28 (31)
11–17	1 (0.2)		8 (9)
18–30	84 (20)		13 (14)
31–50	111 (26)		10 (11)
51–65	101 (24)		3 (3)
66–79	108 (26)		16 (18)
80-	18 (4)		13 (14)
Patient’s mode of arrival at the hospital
Elective	291 (66)		28 (31)
Emergency	150 (34)		63 (69)
	n	Mean (SD)	n	Mean (SD)
General evaluation of the quality of care^a	435	3.87 (1.53)	71	3.18 (1.73)

Notes: Significant others gave feedback on the patient’s care. Valid percent reported (ie, missing cases excluded). ^aLikert scale of 1–5, a higher value indicating stronger agreement with good quality.

Abbreviation: SD, standard deviation.

Table 2 Descriptive Quotes and Structured Evaluative Feedback on Knowledge Processed in Patient’s Care and Services in Free-Form Feedback Including the Empowering Knowledge Areas

The Empowering Knowledge Area	Text Messages		Feedback Forms		Quotes from the Free-Form Feedback
	n	Mean^a (SD)	n	Mean^b (SD)
Biophysiological	1213	3.77 (1.34)	387	3.45 (1.42)	“I would have needed more instructions about what kind of symptoms need further contact again and how long symptoms can prevail”. [ID 1429, text message] “The pain caused by the operation was easier to handle when properly informed of its progress”. [ID 3209, feedback form]
Cognitive	1049	4.31 (1.13)	191	3.80 (1.35)	“I got exhaustive answers to my questions. Home care instructions were also clear and understandable”. [ID 1878, feedback form] “In my digital medical records, there were things recorded that I was not told anything about. I had to google unfamiliar words and I still have not understood everything I read”. [ID 1398, feedback form]
Functional	267	3.83 (1.31)	86	3.69 (1.25)	“The nurse guided the use of the apparatus in an understandable way”. [ID 344, feedback form]
Experiential	140	3.41 (1.43)	41	2.62 (1.33)	“I have a range of experiences since the 1980s. I can value that one is listened to, procedures are well explained first. It was good that previous experiences are discussed before new solutions are offered”. [ID 2580, text message]
Ethical	126	3.52 (1.44)	43	3.92 (1.27)	“Now I need to tell my social security number and personal information about my health in the presence of other patients”. [ID 16303, text message] “Decisions concerning my care were done behind my back, there was no possibility to discuss with the surgeon”. [ID 2165, feedback form]
Social	67	3.21 (1.47)	54	3.05 (1.46)	“Family members could be offered a summarized information package about ADHD symptoms and its effects and how a family member can provide help and understanding”. [ID 16, feedback form] “[Every time my aunt is brought to the emergency room] she has been informed that a close one (me) has been contacted. My phone has not received any message! For a person who does not have a ‘social safety net’ it is very important that the close one gets the information…” [ID 6039, feedback form]
Financial	11	2.36 (1.69)	13	2.45 (1.45)	“The customer was not informed about the changed procedure [for medication allowance]. Not even a cover letter was sent to the customer with the statement”. [ID 4540, feedback form]
		p<0.001		p<0.001

Notes: ^aMean of the structured evaluative feedback item on the understandability of knowledge processed in care and services. Likert scale of 1–5, a higher value indicating stronger agreement. ^bMean of the six structured evaluative feedback items (SumKnow). Likert scale of 1–5, a higher value indicating stronger agreement.

Table 3 Comparison of the Structured Evaluative Feedback (Only Statistically Significant Results Included)

The Empowering Knowledge Area	Patients				Significant Others
	The Area Emerged in the Free-Form Feedback		The Area Did Not Emerge in the Free-Form Feedback		The Area Emerged in the Free-Form Feedback		The Area Did Not Emerge in the Free-Form Feedback
	n	Mean^a (SD)	n	Mean^a (SD)	n	Mean^a (SD)	n	Mean^a (SD)
Cognitive	151	3.99 (1.27)	310	3.62 (1.38)	–
	p=0.006				NS
Experiential	35	2.81 (1.33)	426	3.82 (1.33)	5	1.47 (0.49)	72	3.11 (1.40)
	p<0.001				p<0.001

Notes: T-test. ^aMean of the six structured evaluative feedback items (SumKnow). Likert scale of 1–5, a higher value indicating stronger agreement.

Abbreviations: SD, standard deviation; NS, not significant.

Table 4 The Connection Between Empowering Knowledge Areas Emerged in Free-Form Feedback and the Background Characteristics of Service Users (Only Statistically Significant Results Included)

	Patients				Significant Others
	Biophysiological	Functional	Experiential	Social	Cognitive	Functional	Social	Financial
Patient’s age in years	n (%)
0–10	NS	0 (0%)	0 (0%)	NS	NS	NS	3 (11%)	NS
11–17		0 (0%)	0 (0%)				4 (50%)
18–30		23 (27%)	10 (12%)				7 (54)
31–50		17 (15%)	16 (14%)				4 (40%)
51–65		13 (13%)	7 (7%)				0 (0%)
66–79		10 (9%)	1 (1%)				10 (63%)
80–		4 (22%)	0 (0%)				9 (62%)
p-value		0.02	0.004				0.002
Patient’s gender
Woman	NS	NS	NS	19 (5%)	12 (24%)	NS	NS
Man				1 (1%)	25 (46%)
p-value				0.023	0.018
Patient’s mode of arrival at the hospital
Elective	NS	NS	NS	NS	NS	NS	NS	3 (11%)
Emergency								1 (2%)
p-value								0.05
Evaluation of the quality of care (agreement with the good quality)
Completely disagree	56 (82%)	NS	17 (25%)	NS	NS	3 (14%)	NS	NS
Partially disagree	29 (85%)		5 (15%)			0 (0%)
Does not agree nor disagree	24 (77%)		4 (13%)			3 (43%)
Partially agree	38 (69%)		2 (4%)			0 (0%)
Completely agree	152 (62%)		6 (2%)			1 (4%)
p-value	0.002		<0.001			0.02

Notes: Chi-Square Test. The percentage represents the distribution of free-form feedback including the empowering knowledge area, among all the knowledge-related free-from feedback given by service users with the background characteristics in question.

Abbreviation: NS, not significant.