Examining Individual Experiences in Healthcare Services
A Qualitative Analysis
October 3, 2013

Introduction All individuals need or will need healthcare throughout their lifetime. The issue of care and how people feel about the way they are treated by physicians and staff members, as well as, the cost involved in treatment are vital aspects of patient rehabilitation. If an individual is not satisfied with the healthcare services provided, they will not continue with the treatment plan and therefore, go without managed care which can affect their quality of life. The purpose of this study was to examine common factors and experiences of adult students and to also compare the quality of healthcare among social class.
Research Question This study seeks to answer the following research question: What factors affect the healthcare experiences of the adult learner?
Literature Review One of the peer reviewed journal articles that I read relevant to this to this subject was titled Practice, Policy, & Perspectives; A Survey Evaluating Patients’ Satisfaction with the Social Work service provided at a Rehabilitation Centre from an Australian Social Work Journal published by Routledge in March 2012. It exemplified the need to develop relationships between patients and the administrators of healthcare services to achieve satisfaction of complete care. The study proclaimed that patient satisfaction is an important indicator in the quality of healthcare. Iliffe et al. (2008) noted, healthcare service users have strong views about their care and are best placed to judge aspects of this care. Patient satisfaction is part of the definition of quality. Service users should have the right to influence their care and the services they receive.
Iliffe et al. (2008) also stated that, “patient satisfaction is important to rehabilitation because patients’ motivation, perceptions, and compliance with treatment are all influenced by their level of satisfaction or dissatisfaction with their healthcare’. Considering this view, patient satisfaction should be essential to healthcare evaluation and is needed to help the patient sustain interest in their care.
Mangset et al. (2008) found that being treated with respect and dignity was a core element that influenced patient satisfaction. Individuals want to be treated with humanity.
The other article that I read called Lessons learned from children who have experienced homelessness: what services need to know from the Children & Society Journal published by the National Children’s Bureau also took a qualitative approach to develop an understanding of experiences. It discussed how semi-structured interviews, art activities and group discussions were used to gather individual perspectives. After some insight, the information was analyzed for themes that surfaced among the group of participants. This article is related to my study because of the method used to gather information and the purpose to explore individual perceptions and experiences.
Process
Conducting a focus group as a way to gain insight on a particular subject was a great way to collect individual ideas. Realizing an area of interest was quite challenging though because there are many issues that could be discussed. Once I choose my area of interest, I then established a research question specific enough to draw interest from the group. I also developed five sub-questions to further explore the subject.
At the start of our meeting, even though all four members knew me, I introduced myself and had them do the same. I then introduced the purpose of my study and posed the question at hand. As individuals narrated their personal experiences, I took notes while attentively listening to each person’s perspective. This was not an easy task. Being an amateur facilitator, I was not able to watch for non-verbal communication such as body language for clues because I was too busy taking notes. I also had trouble jumping into the conversation by giving my view which prevents gathering the perspectives of the group.
Sample
The sample consisted of a group of adult students in the bachelor of science social work program completing their degree from 2010-2014 at a private university in the southeast. The group dynamics included one male and three female students between the ages of 21-35 years old. The second half of my question pertaining to social class could not be explored considering these individuals all basically had the same economic level.
Methodology
This focus group was used as a convenient non-probability sample, using an exploratory, qualitative research design to collect perspectives on healthcare services which involved data collection through discussion and transcription.

Results
Healthcare Experiences The themes and sub-themes within the focus group were discovered using an open and axial coding process. After determining the initial concepts and categories, I was then able to identify central phenomenon and influencing consequences that lead to their individual experiences. Most group members had a general healthcare experience which included basic services provided by a private physician or clinic. Each member described how they felt as though they were treated like a number. They expressed that the attitudes of some health professionals were uncaring and there was a lack of interest pertaining to relationship development between patients and staff members. Limited communication with the physician administering the treatment plan and the lack of compassion expressed toward patient needs was another theme that surfaced within the group. Most members wanted the care giver to understand their plight and give positive feedback or solutions to their problems.
Healthcare Costs Some members had no health insurance therefore; seeking healthcare services were out-of-pocket expense that added to their cost of living. Even those that were covered by a health insurance plan still had out-of-pocket expenses such as co-pays each visit, prescription cost, and deductibles required before specialized services were rendered. There were also lab fees and the possibility of a separate bill from the physician and the facility administering the services. Limitation of services per insurance coverage was yet another conflict. Some plans only allowed annual exams without additional billing involved. Lack of confidence in the healthcare system was the overall theme that existed among the group members. The cost of healthcare was an added expense to the household with or without health insurance and the services rendered was limited to affordability. October 1, 2013 marked the opening day to apply for state & federally funded health insurance exchanges offered through the Healthcare Reform Act which will allow individuals to purchase health insurance separate from their employer. Middle and low-income families may qualify for federal subsidies that will reduce premiums and out-of pocket health expenses.
One of the members of the group stated that, “I am indifferent about healthcare reform because I believe that the level of care will not change and some doctors may not accept payment from the new healthcare exchanges that are being offered”. So even though the Healthcare Reform Act has now gone into effect, people are apprehensive about the covered that they will receive.
Another member of the group argued that, “Low-income people are being forced to purchase health insurance or be penalized under the new system. People still can’t afford the added expense. Healthcare should be an option.” This individual feels this way because they are being made to purchase health insurance that they cannot afford.
Implications for the future and conclusions
As stated in the first peer reviewed article, according to Mangset et al. (2008), in a study involving older people and their care they found that a professional and humanitarian approach was perceived as a vital element in the satisfaction of care. People want to be treated with respect and acknowledged as individuals.
Implications
The implication is that dialogue and exchange of information on a personal level is required for complete care. Evaluating patient satisfaction increases the quality of healthcare for the individual. If an individual is satisfied with the quality of care received, they are more than likely motivated to complete the treatment plan prescribed for them enabling them to be more successful in the rehabilitation process.
Future Research Replications of this study from a larger institution with a more diverse population of individuals of different socioeconomic backgrounds are needed to compare differences in healthcare experiences. Further exploration of the experiences of social class is needed to give more insight. Also, further exploration of limitation of services per insurance plan is needed to examine the differences in premium cost and what is offered as plan covered. Today, due to the Healthcare Reform Act, it is important to identify outcomes of the new “insurance exchanges” being offered to middle and low-income families. Developing research that explores the outcomes or satisfaction of the healthcare exchange programs offered through state and federal governments will be necessary. Quality healthcare is vital to individual well-being. Everyone should have the opportunity to seek healthcare and not have fear that the quality of care will be given according to their financial status. In my option, healthcare should be a Basic Human Right. References

Iliffe, S., Wilcock, J., Manthorpe, J., Moriarty, J., Cornes, M., Clough, R., Bright, L., & OPRSI. (2008). Can clinicians benefit from patient satisfaction surveys? Evaluating the NSF for older people. Journal of the Royal Society of Medicine, 598-604.
Mangset, M. D. (2008). We're just sick people, nothing else':factors contributing to elderly stroke patients' statisfaction with rehabilitation. Clinical Rehabilitation, 876-884.
Manthorpe, J. M. (2008). "There are wonderful wonderful social workers but its's a lottery: Older people's views about social workers. British Journal of Social Work, 1132-1150.
Roberts, K. S. (2012). Practice, Policy, & Perspectives a survey evaluating patients statisfaction with social work service provided at a rehabilitation centre. Australian Social Work, 145-155.