Validating the accuracy of the resident satisfaction measure.

Amidst its growing popularity as an outcome measure of the service quality of residential aged care, self-reported resident satisfaction is criticized as non-discriminating since most residents tend to give very high satisfaction scores. Three explanations are identified from the literature to account for the apparent positivity bias of the satisfaction measure: namely consumer factors, the service nature of residential aged care and methodological pitfalls. Drawing on a cross-sectional survey of 405 Chinese residents across 11 randomly selected publicly funded care homes in Hong Kong, this paper highlights what could be done to deal with some of the methodological artefacts. This includes the construction and use of the four-item "Residential Care Satisfaction Scale" instead of a single satisfaction item, the adoption of a vigorous sampling method such as stratified random sampling in the selection of facilities, the inclusion of residents suffering from cognitive and/or physical impairment, and the empowerment of participants. Five cultural factors are then suggested to account for the participants' high satisfaction ratings of their facilities. The paper ends with further suggestions for enhancing the validity and usefulness of the self-reported satisfaction measure.