Beyond the ceiling effect: Using a mixed methods approach to measure patient satisfaction

This study reports patient satisfaction with the nursing care on a neurosurgical critical care unit. A modified version of the Ludwig-Beymer Patient Satisfaction Questionnaire (PSQ-7) was used, and included structured items and semi-structured interview questions. Data were collected from 149 patients. Participants rated their satisfaction as high (Mean = 25. 14; SD = 2. 96). The distribution of scores was skewed and every item demonstrated a ceiling effect. Principal com-ponent analysis yielded a one-component solution which explained 48% of the variance. ® was used to match PSQ-7 scores with qualitative data. Participants' comments were categorised as positive, negative or ‘yes, but’. Just over half the patients made positive comments and 29% of patients in the low group made negative comments. Three categories: ‘communication’, ‘nursing care delivery’ and ‘the hospital environment’ emerged from the qualitative data. mixed method approach enables researchers to move beyond the ceiling effect of quantitative measures of patient satisfaction and to gain a more mean-ingful explanation of patient satisfaction