Can patient satisfaction improve health among patients with angina pectoris?

Objective. To identify and explore the components of patient satisfaction that have the strongest association with health-related quality of life among patients with angina. Design. Cross-sectional study with postal questionnaires sent to patients 6 weeks after discharge from hospital, followed-up by one reminder. Setting. The Central Hospital of Akershus in Norway Study participants. All 589 angina patients discharged between January 1 1995 and December 31 1996. The response rate was 67% (n=395). Main outcome measures. Physical and mental component summary scales in SF-36. Results. When adjusted for relevant background factors such as age, sex, education, social network, health behaviour and sense of coherence, patient satisfaction explained 9% of the variation in the physical, and 7% of the variation in the mental component summary scales. In particular, satisfaction with medical treatment (P=0.002) and with information (P=0.003) were associated with improved physical and mental health-related quality of life. Patients who experienced their physicians as caring and competent were more likely to be satisfied with the medical treatment and with the information. Sense of coherence contributed to health-related quality of life both directly, and through improving patient satisfaction. Conclusion. This cross-sectional study supports the hypothesis that patient satisfaction contributes to both physical and mental health-related quality of life. Other research designs are needed to assess whether the associations identified are truly causal.