Explanatory models of influences on the construction and expression of user satisfaction

Atkinson, S.; Medeiros, R.

Abstract

The paper asks why high levels of expressed satisfaction are recorded in settings where health care provision is manifestly inadequate. Qualitative interviews with 30 women aged 25–60 years from a rural district health system of Northeast Brazil were used to explore the applicability of three explanatory models of influences on the construction and expression of satisfaction: expectations; contextual dynamics; mediating filters. The first two of these models argue that a lack of information and a reluctance to be negative respectively lead to high expressed satisfaction that is artificial. The concept of mediating filters proposes that respondents construct an evaluation that takes account of wider issues, such that high levels of expressed satisfaction are, in this sense, real. All three models contribute towards answering the paper's question. However, our data suggest that it is an informed, but low, expectation of health care provision that leads to alternative strategies, including resort to patron–client networks, and success in gaining good health care that is important. Mediating filters identified in this study were culpability and the reference time-frame. We raise questions for practice and offer a combined explanatory model.

Citation

Atkinson, S., & Medeiros, R. (2009). Explanatory models of influences on the construction and expression of user satisfaction. Social Science & Medicine, 68(11), 2089-2096. https://doi.org/10.1016/j.socscimed.2009.03.042

• Journal Article Type: Article
• Publication Date: Jun 1, 2009
• Deposit Date: Aug 12, 2009
• Publicly Available Date: Aug 17, 2009
• Journal: Social science and medicine
• Print ISSN: 0277-9536
• Electronic ISSN: 0277-9536
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 68
• Issue: 11
• Pages: 2089-2096
• DOI: https://doi.org/10.1016/j.socscimed.2009.03.042
• Keywords: Satisfaction, Experience, Evaluation, Time-frame, Contextual dynamics, Expectations, Mediating filters, Brazil, Healthcare, Women
• Public URL: https://durham-repository.worktribe.com/output/1550748