A critical analysis of user satisfaction surveys in addiction services: opioid maintenance treatment as a representative case study

Figures & data

Table 1 Levels of user-participation or opportunities for user-participation in addiction treatment and harm reduction services

Degree of user involvement	Type of participation	Example of activity
High	Activities implying a share in decision-making	User’s representatives involved in service planning committees
		User’s representatives attending staff meetings
		User’s representatives involved in staff recruitment
		User’s representatives involved in staff performance appraisal
Mild	Activities in which service users have nondecision-making roles	Users involved in writing or reviewing informative fact sheets or educational materials
		Users involved in staff training
	Activities promoting and supporting user involvement	Availability of an adequate space and schedule within the service to run users own support groups
		Availability of publications or information about the activities of drug user organizations
Low	Activities related to providing information to or receiving information from service users	User councils
		User forums
		User satisfaction surveys
		Suggestion box
		Complaint process
		Adequate display of information concerning changes on policies or service hours
	User-participation built into the values and policies of the service	Charter of rights

Notes: These levels represent a range of opportunities for user-participation. In practice, and due to very diverse reasons (eg, availability of the activity by the service or user’s awareness and motivation), participation does not occur in all of these areas, in all services, or in the case of all users. Adapted with permission from Bryant J, Saxton M, Madden A, Bath N, Robinson S. Consumer participation in the planning and delivery of drug treatment services: the current arrangements. Drug Alcohol Rev. 2008;27(2):130–137. Copyright © 2009, John Wiley & Sons.⁵¹

Table 2 Classification of instruments to measure patient satisfaction according to the degree to which they incorporate the patient’s own perspective

Type	Description
Patient satisfaction scale developed by patients	A patient satisfaction scale (PSS) developed by patients (PSS-DP) is a PSS developed completely from the patients’ perspective. The main differentiating characteristic of this type of PSS lies in the fact that all those involved in the different phases of its development are (or have been) recipients of the service to be evaluated.
Patient-centered satisfaction scale	A patient-centered PSS (PSS-CP) is a PSS that explicitly incorporates, to a greater or lesser extent, the patients’ perspective. Even though other stakeholders (eg, clinicians, researchers, family members, and/or administrators) have participated in developing the instrument, the patients themselves have made major contributions, usually in the initial phases of 1) generating the domains or variables to be evaluated, 2) writing the questions, and/or 3) evaluating some characteristic of the initial or pilot version of the instrument (eg, pertinence or comprehensibility of the items).
Patient satisfaction scale valued by patients	A PSS valued by patients (PSS-VP) is a PSS that, developed without direct patient participation, is considered as such (ie, valued or appreciated) by most of them because it reflects, at least in part, their perspectives. To determine whether a PSS developed without patient participation can be considered patient-valued, qualitative research methods such as focus groups or cognitive interviews must be performed.
Patient satisfaction scale irrelevant to patients	A PSS irrelevant to patients (PSS-IP) is a PSS that has been 1) entirely developed without any patient participation, and 2) assessed by patients as irrelevant or of no interest or value. A priori, assuming no additional information is available, any PSS developed without any direct patient participation should be placed, at least provisionally, in this category.

Note: Data from Trujols et al.¹²²

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