A Discrepancy Model for Measuring Consumer Satisfaction with Rehabilitation Services

The need for increased consumer involvement in rehabilitation services has often been emphasized in professional literature. Unprecedented social change, legislative initiatives, growing empowerment among consumer groups who demand informed choice, and changes in current service intervention strategies, individually and collectively, have contributed to a heightened interest in the opinions of the persons who utilize rehabilitation services. Furthermore, the long-range impact of the Americans with Disabilities Act (ADA) of 1990 on service needs of persons with disabilities is beginning to be clarified. Its impact may well prove to be as far reaching as the Rehabilitation Act of 1973. If so, a surge in consumer involvement in all areas of rehabilitation services planning is anticipated. As empowered consumers continue to voice opinions regarding their service needs, the effectiveness of current services will be of greater interest to providers. Consumer opinion, nonetheless, should be solicited to insure that knowledgeable consumers are more involved in the assessment of current services as well as in the development of more effective services. Many researchers and practitioners are supportive of consumer opinions as a viable research option. Experts suggest that discussions continue regarding issues surrounding increased consumer involvement in service planning and how to more effectively use satisfaction research information in planning efforts (Bativia & DeJong, 1991; Fawcett, 1991; Kosciulek, Rosenthal, Vessell, Accardo & Mertz, 1997; Stubbins, 1984). Discussions on obtaining clients' perspectives in planning services and determining the usefulness of those services continue. However, two issues remain (a) agreement as to how this information can best be obtained, and (b) the usefulness of the information. The primary purpose of this paper is to explore ways that would maximize consumer participation in service planning and evaluation by more effectively assessing consumer opinions. Increased participation of consumers in the research and exploration of more meaningful means of arriving at their opinions has been suggested by many experts in the consumer satisfaction area as viable research options (e.g. Bativia & DeJong 1990; Fawcett, 1991; Kosciulek et al 1997; Phillips, 1985; Taylor, Raccino, Knoll & Lutifyys, 1987; Williams, 1994). Historically, discussions of consumer satisfaction in human services have revolved around such questions as: (a) at what levels should clients be involved in service planning? (b) should and can, consumers be asked to determine the quality of specialized professional services such as rehabilitation services? (c) if consumers are more involved in service planning, to what extent should they be encouraged to participate in the process? and, (d) do current services meet real and perceived needs of persons receiving the services? (Johnson & Fawcett, 1987; Morrison, 1991; Stubbins, 1984). Two a priori assumptions herein, are that (a) consumers should be involved in all aspects of service planning, and (b) an initial step for researchers is to develop better measures of determining consumers' perceptions of services, planning, and evaluation of impact. In regard to obtaining consumer opinion, social learning researchers, such as Bandura (1977) and Hawkins (1991), have stressed that the needs of persons seeking services are individualized. Consequently, their expectations and perceptions of services will likely impact the success, failure, and their opinions of services received. Research reports that dissatisfaction/satisfaction is related to individual cognitive discrepancies between a social ideal (collective expectations) and the personal experience of reality (individual perceptions) (Higgins, 1987). The social learning model has served as a theoretical base for human service satisfaction research (Bandura, 1977; Caeser, 1997; Fawcett, 1991; Gotlieb, Grewal and Brown, X1984; Higgins; 1987). …