Children's conceptualization of the term 'satisfaction': Relevance for measuring health outcomes

Background: Health outcomes measurement is integral to planning and evaluating paediatric health care. Recent outcome measures have been developed to capture children's participation in everyday activities, a core component of which is the child's perceived satisfaction. Satisfaction, however, is a complex concept and it is not known how children conceptualize satisfaction and hence how it should best be measured. The purpose of this study was to explore children's conceptualization of the term 'satisfaction' and compare this with the description of satisfaction given in the literature to inform how satisfaction can be assessed in children. Methods: Forty children aged between 10 and 15 years participated in eight focus groups, guided by a descriptive qualitative approach, to describe how they conceptualize 'satisfaction'. Children with disabilities were excluded as it was considered important to first ascertain how children without disabilities conceptualize satisfaction. Recruitment occurred through seven urban and rural public schools. Data were analysed using qualitative content analysis. Results: Participants identified three methods by which a person may determine their level of satisfaction (i) making comparisons with previous experiences, and other's and self-expectations; (ii) evaluating one's emotions; and (iii) receiving positive external feedback. Participants described drawing upon one of these methods in isolation, rather than integrating outcomes from each method into one judgement of satisfaction. Participants also demonstrated confusion between the terms 'satisfaction' and 'satisfactory'. Conclusions: Partial congruence between children's conceptualization of satisfaction and that reported in the literature was observed in this study. Not all children between the ages of 10 and 15, however, have a full understanding of satisfaction. Caution must therefore be taken when using the term satisfaction in children's assessments to minimize the potential for varying interpretations of the question. Further studies are required to explore how children with disabilities view the term satisfaction and if their understanding differs to that of typically developing children.