Patient satisfaction is an abstract and multidimensional concept that is recognized to be an important component of evidence-based health care. Although there have been increased attempts to develop and use standardized, patientreported outcome (PRO) measures for the evaluation of satisfaction with rehabilitation services, analogous efforts in orthotics and prosthetics (O&P) are less common. Measuring satisfaction in O&P may be challenging because patients' satisfaction is derived from their experiences with both the services and the devices provided. Similarly, patients' experiences with orthoses may differ from prostheses, because their motivations for use may be different. The purpose of this literature review is to identify and appraise PRO instruments that have been used to assess satisfaction with orthotic devices and services. A secondary purpose is to advocate for measures that are suitable for an O&P clinical environment. A systematic search of medical databases was conducted using a combination of the terms "satisfaction" and "orthotic" (and related synonyms, such as "orthosis" and "orthoses"). Publications were selected for review if they identified instruments that were administered with a clear and standardized protocol by an orthotist or a pedorthist to patients or participants with a diagnosis indicating orthotic intervention. The reviewed measures were classified as either formal (i.e., had an established history of psychometric development) or ad hoc (i.e., had not undergone formal psychometric testing of any kind). For each reviewed measure, the subdomains (i.e., determining factors of satisfaction) were identified through a review of the measure's items and the body of the associated publication(s). Fourteen publications met the selection criteria and were chosen for review. Publications dates ranged from 1989 to 2009, and studies included a variety of orthotic devices (e.g., ankle-foot orthoses, knee-ankle-foot orthoses, cranial helmets, spinal, etc.). Seven ad hoc and four formal PRO instruments were identified in the review. Formal measures included the Orthotics and Prosthetics Users' Survey (OPUS), the modified SERVQUAL instrument, the Quebec Users' Evaluation of Satisfaction with assistive Technology 2.0, and the Scoliosis Research Society 22/24 questionnaire. Seventeen subdomains of satisfaction were identified within the reviewed outcome measures. Eight subdomains pertained to device satisfaction (e.g., cosmesis or comfort), eight subdomains contributed to satisfaction with services (e.g., competence or communication), and one (i.e., overall satisfaction) was applicable to both device and service domains. The OPUS and SERVQUAL were identified as measures that may be well suited to the assessment of orthotic services (SERQUAL and OPUS) and devices (OPUS) in a clinical environment. Future research is recommended to focus on the use of standardized measures of satisfaction and dissemination of experiences with these instruments. (J Prosthet Orthot. 2011;23:95-105.)
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