Satisfaction with palliative care: what should we be aware of ? Review Article

This review addresses some of the methodological, theoretical and technical issues related to using satisfaction as an outcome measure of the quality of palliative care. The components of palliative care are presented, and the different approaches for evaluation discussed. The limitations of using prospective or retrospective designs are stated with emphasis on the bias resulting from using either patients or carers (proxies) as informants. The role of expectations, aspirations, and perceived health status as antecedents of patient satisfaction is discussed, as are the problems associated with using these to explain satisfaction with palliative care. The limitations of adapting the dimensions of patient satisfaction with medical care to satisfaction with palliative care when designing instruments are discussed. All this highlights the need to develop separate models of satisfaction with palliative care for patients and carers, and to design instruments which are specific to patients or carers.