Qualitative techniques to investigate how patients evaluate dentists: a pilot study

Most previous studies have portrayed patient satisfaction as a rather simple outcome based solely on patient perceptions. The goal of this pilot study was to determine if evidence could be found to support the view that patient evaluation is a more complex process better explained by drawing on the theories of 'disconfirmation of expectations' and 'attribution'.

A qualitative methodological approach was chosen with data collection being achieved by means of four focus group interviews comprising a total of 25 participants (16 women and 9 men, mean age 43.8 years, standard deviation of 14.45) representing a wider population of adults (over the age of 18) who had attended for dental treatment within the previous 12 months.

Analysis suggests that patient perceptions of dental practice alone do not fully account for the way patients evaluate dentists. Disconfirmation of expectations does take place during the evaluation process. Equally, patients appear to apply the attributional concepts of 'duty' and 'culpability' to determine either satisfaction or dissatisfaction.

A better understanding of patient satisfaction, and the evaluation process that leads to satisfaction, can only be achieved if, in addition to patient perceptions, other antecedent factors such as patient expectations and desires are considered. Disconfirmation and attribution theory do appear to play an important role in this process and warrant further investigation.