Free
Poster Session
Issue Date: July 01, 2015
Published Online: February 09, 2016
Updated: January 01, 2020
Factors Predicting Client Satisfaction in Occupational Therapy and Rehabilitation
Author Affiliations
  • Retired, St. Louis, Missouri
  • Eastern Kentucky University
Article Information
Rehabilitation, Participation, and Disability / Assessment/Measurement
Poster Session   |   July 01, 2015
Factors Predicting Client Satisfaction in Occupational Therapy and Rehabilitation
American Journal of Occupational Therapy, July 2015, Vol. 69, 6911500091. https://doi.org/10.5014/ajot.2015.69S1-PO3048
American Journal of Occupational Therapy, July 2015, Vol. 69, 6911500091. https://doi.org/10.5014/ajot.2015.69S1-PO3048
Abstract

Date Presented 4/17/2015

In this research, we tested a logistic regression model of satisfaction. Using the the Satisfaction with a Continuum of Care—Revised (SCC–R), we collected data on 769 clients. The most robust predictors of satisfaction were improvements in functional status, especially self-care.

SIGNIFICANCE: Satisfaction is a relevant outcome for occupational therapy and rehabilitation that contributes to describing the value of treatment interventions and to documenting its relevance to the client’s needs. Studies of client satisfaction are routinely limited by inflated satisfaction scores usually attributed to respondents’ reluctance to report undesirable ratings for their providers. Logistic regression requires that the dependent variable be defined as either “satisfied” or “dissatisfied,” and establishing a cutoff point for satisfaction and dissatisfaction is an important challenge in measurement analysis.
INNOVATION: There has been relatively limited development of models to describe the relationship among factors influencing satisfaction, although in a 2005 study, Brown advocated for using predictive modeling of outcomes in rehabilitation facilities.
METHOD: In this study, we attempted to answer the following research questions: How does functional status at admission and discharge contribute to models of client satisfaction? How does the rehabilitation processes contribute to models of client satisfaction? How do the client’s gains contribute to models of satisfaction? How does occupational therapy contribute to models of satisfaction?
The purpose of this descriptive study was to test the predictors of satisfaction of rehabilitation and occupational therapy conducted in partnership with a regional rehabilitation hospital (RRH). All clients aged 18 yr and older as RRH inpatients and/or outpatients over a 27-mo period received the Satisfaction with a Continuum of Care—Revised (SCC–R), a measure of satisfaction containing two subscales: Clinical Quality and Client Centeredness. The RRH provided the Functional Independence Measure (FIM) data, measuring functional status and other client medical data. Clients provided informed consent with institutional review board (IRB) approval. Binary logistic regression analyses using the Forced Entry method were chosen to test the predictors of satisfaction for each research question. The FIM self-care scores at admission and discharge were isolated as a variable of relevance to occupational therapy.
RESULTS: FIM self-care scores at discharge were predictive of satisfaction; clients were 4.2% more likely to be satisfied. Admission to rehabilitation within 15 days of onset and total number of rehabilitation hours were significant in predicting satisfaction. Change in total FIM scores from admission to discharge and FIM self-care change scores were significant predictors of both satisfaction with client centeredness and clinical quality. The most consistent findings were that admission and discharge functional status and improvement in functional status, especially self-care ability, were robust predictors of satisfaction with both clinical quality and client centeredness. For every 1-point increase in FIM self-care scores (e.g., eating, bathing, toileting, dressing) at discharge, clients were 42% more likely to be satisfied on the Client Centeredness subscale.
CONCLUSION: This study was a naturalistic and applied study; clients were not randomized to any condition. The cutoff point for prediction could have been set higher or lower using logistic regression to test the sensitivity of different definitions of satisfaction. Despite these limitations, this study included a fairly typical sample of a rehabilitation population.