Distinguishing patient satisfaction with treatment delivery from treatment effect: A preliminary investigation of patient satisfaction with symptoms after physical therapy treatment of low back pain

George SZ, Hirsh AT. Distinguishing patient satisfaction with treatment delivery from treatment effect: a preliminary investigation of patient satisfaction with symptoms after physical therapy treatment of low back pain. Arch Phys Med Rehabil 2005;86:1338-44. Objective: To investigate the discrepancy between ratings of pain intensity and patient satisfaction by evaluating a questionnaire item that assesses patient satisfaction with treatment effect. Design: Inception cohort. Setting: Ambulatory care. Participants: Sixty-six consecutive patients referred to outpatient physical therapy (PT) with acute low back pain (LBP). Intervention: PT using treatment-based classification guidelines. Main Outcome Measure: Patient satisfaction 6 months after receiving PT for LBP. Results: Patient satisfaction with symptoms was considerably lower than the other patient satisfaction items. Patient satisfaction with symptoms was responsive to measures of treatment effect (Spearman p range,.36-44, P <.01) and with whether expectations were met (Spearman p=.45, P<.01). Patients who were satisfied with symptoms reported higher physical function, lower pain intensity, and less symptom bothersomeness (P <.01) at 6 months. The 2 strongest absolute and unique predictors of patient satisfaction with symptoms at 6 months were whether treatment expectations were met and change in symptom bothersomeness. Conclusions: This study suggested that a questionnaire item assessing patient satisfaction with symptoms allows patients to distinguish between satisfaction with treatment effect and treatment delivery. (c) 2005 by American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.