Factors behind dialysis patient satisfaction: exploring their effects on overall satisfaction.

We would establish a construct of dialysis patients' satisfaction and identify their contribution to overall satisfaction. We also seek to identify present satisfaction levels of Japanese dialysis patients and some important characteristics of their satisfaction/dissatisfaction. A self-administered questionnaire for measuring dialysis patient satisfaction was developed, which comprised 32 closed-ended satisfaction question items that were facet-specific, three items on overall satisfaction, four items on respondent's health status and quality of life as well as demographic information. Reliability and validity of the questionnaire was verified. A questionnaire-based survey was conducted between July and September 2013. A total of 807 valid responses (63% of response rate) were collected from dialysis patients in 22 facilities located in most regions of Japan. Seven satisfaction factors were derived with 65% of cumulative variance accounted for by applying principal component analysis to responses to facet-specific satisfaction items. More than 80% of patients expressed positive overall satisfaction and that they wished to continue dialysis therapy in the current facility (they can change dialysis facilities if they wish to). Dialysis patients' overall satisfaction was formulated significantly by five out of seven satisfaction factors by regression analysis. Japanese dialysis patients expressed their high satisfaction with and strong loyalty to the facility where they currently receive dialysis therapy (i.e., patient loyalty). The more satisfied dialysis patients were with the facility, the stronger loyalty they would like to maintain. The overall satisfaction was critically determined by their satisfaction with clinical environment, equipment, treatment and therapy. In addition, patients' quality of life was highly associated with their overall satisfaction.