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Objectives: Theories of patient satisfaction with treatment outcome have not been developed and tested in healthcare settings. The objectives of this study were to test a new theory linking patient satisfaction and embodiment (body--self unity) and examine it in relation to other competing theories., Design: We conducted a prospective cohort study., Setting: This study was conducted at a tertiary care hospital., Patients: We studied 122 individuals undergoing elective hand surgery., Methods: Satisfaction with treatment outcome approximately 4 months after surgery was examined against the following factors (representing 7 theories of satisfaction): 1) overall clinical outcome, 2) patients' a priori self-selected important clinical outcomes, 3) foresight expectations, 4) hindsight expectations, 5) psychologic state, 6) psychologic state in those with poor outcomes, and 7) embodiment., Analysis: Seven hypotheses were tested first using univariate analyses and then multivariable regression analysis., Results: Satisfaction with treatment outcome was significantly associated with embodiment. Three confounders--the extent to which surgery successfully addressed patients' most important reason for surgery, hindsight expectations, and workers' compensation--were also significant. The final model explained 84% of the variance in a multidimensional measure of satisfaction with treatment outcome., Conclusion: This research suggests that satisfaction with treatment outcome could be facilitated by developing strategies to improve body--self unity, and eliciting and addressing the patient's most important reason for undergoing treatment.

Objective: Although satisfying patients is an important goal in health care, what is meant by satisfaction in relation to treatment outcome is not clear. The objective of this study was to explore patients' perspectives on the meaning of satisfaction with treatment outcome., Design: We conducted a qualitative exploratory study., Setting: This study was conducted at an adult tertiary care hospital., Patients: Individuals who had undergone elective hand surgery were included in this study., Intervention: In-depth, open-ended interviews in which 31 participants described their experience of a hand condition, how they evaluated the outcome of surgical interventions, and what it meant to be satisfied or dissatisfied with these outcomes were examined., Analysis: : Interview transcripts were analyzed using Gadow's conceptualization of embodiment states: "object body" (disunity between the affected hand and the self) or "cultivated immediacy" (harmony between the hand and the self)., Results: Eight of 9 dissatisfied individuals were categorized as "object body" and 15 of 19 satisfied individuals were in, or in transition to, "cultivated immediacy". These states fluctuated and were also dependent on context (eg, social setting) and time since surgery., Conclusion: In relation to the outcome of hand surgery, satisfaction was experienced as a relative lack of tension between the patient's sense of self and the affected hand (ie, satisfaction was having a hand that could be lived with unself-consciously). Emotional and social effects of interventions and the influence of context should be considered in future measures of satisfaction with treatment outcome. Finally, interventions directed toward facilitating patients' experience of body-self unity could promote satisfaction with treatment outcome.