Personality characteristics associated with satisfaction with healthcare and the wish to complain

Background
 There is increasing evidence that satisfaction with healthcare and complaint rates vary with patients’ socio-demographic characteristics. Likewise, patient personality might influence the perception of health care; however, empirical research has been scarce. The aim of this study was to investigate associations between health care user personality and satisfaction with care and urge to complain. Methods This study is a randomized survey among Danish men aged 45 to 70 years (N = 6,756; 30% response rate) with hypothetical vignettes illustrating different courses of healthcare. Assuming they received the care described in vignettes, participants rated their satisfaction and wish to complain on a five-point Likert scale. Information on personality characteristics was obtained through self-reports using the standardized Big Five Inventory-10 (BFI-10). Results In multivariate analyses, we found respondents with higher scores on the agreeableness dimension expressing greater satisfaction with care (Likert difference 0.06, 95% CI 0.04 to 0.07; p < 0.001) and decreased wish to complain (-0.07, 95% CI -0.08 to -0.05; p < 0.001) while high neuroticism scores were associated with less satisfaction (-0.02, 95% CI -0.03 to -0.00, p = 0.012) and an increased wish to complain about healthcare (0.04, 95% CI 0.03 to 0.06, p < 0.001). Interaction analyses could demonstrate no statistically significant interaction between the level of patient involvement in decision making in the scenarios and the effect of personality on respondents' satisfaction and wish to complain. Generally, however, when adjusting for personality, respondents’ satisfaction increased (P < 0.001) with greater patient involvement illustrated in case scenarios while the wish to complain decreased (P < 0.001). Conclusion Our findings suggest low agreeableness and high neuroticism scores are associated with lower patient satisfaction with healthcare and increased wish to complain. Irrespective of personality, however, the wish to complain seems responsive to changes in patient involvement, underscoring the importance of inclusive healthcare communication. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08688-7.

enzyme produced by the male prostate gland that can be measured in blood. The test is used for diagnostics and control of prostate cancer treatment. PSA blood levels normally increase with age, prostate gland enlargement, and if the prostate is sick (e.g., cancer). However, an increased PSA does not necessarily mean that you have prostate cancer. The doctor then tells you that 'it is not common' to test all for prostate cancer with PSA because the test is not good enough. One can for example have increased PSA in the blood without having prostate cancer. In addition, prostate cancer may develop slowly so that you experience no prostate cancer symptoms before dying from other causes. Furthermore, the treatment of prostate cancer may have significant side effects.
Therefore, the doctor would suggest himself not to have a PSA test done. You decide NOT to have a PSA test done.
Finally the doctor concludes that everything seems ok -that you are as healthy as you look, but that 'as a doctor you can of course not issue guarantees', and that you should see your doctor, 'if something new turns up and by the way, I will see you in 14 days to review your test results'.
Your doctor tells you about a blood test for prostate cancer. It is called PSA. PSA is a natural enzyme produced by the male prostate gland that can be measured in blood. The test is used for diagnostics and control of prostate cancer treatment. PSA blood levels normally increase with age, prostate gland enlargement, and if the prostate is sick (e.g., cancer). However, an increased PSA does not necessarily mean that you have prostate cancer. The doctor then tells you that 'it is not common' to test all for prostate cancer with PSA because the test is not good enough. One can for example have increased PSA in the blood without having prostate cancer. In addition, prostate cancer may develop slowly so that you experience no prostate cancer symptoms before dying from other causes. Furthermore, the treatment of prostate cancer may have significant s ide effects.
Therefore, the doctor would suggest himself not to have a PSA test done. You decide to have a PSA test done anyway.
Finally the doctor concludes that everything seems ok -that you are as healthy as you look, but that 'as a doctor you can of course not issue guarantees', and that you should see your doctor, 'if something new turns up and by the way, I will see you in 14 days to review your test results'.
(STEP 2 -MAIN VARIANT 3a) Your doctor tells you about a blood test for prostate cancer. It is called PSA. PSA is a natural enzyme produced by the male prostate gland that can be measured in blood. The test is used for diagnostics and control of prostate cancer treatment. PSA blood levels normally increase with age, prostate gland enlargement, and if the prostate is sick (e.g., cancer). However, an increased PSA does not necessarily mean that you have prostate cancer. The doctor then tells you that 'it is not common' to test all for prostate cancer with PSA because the test is not good enough. One can for example have increased PSA in the blood without having prostate cancer. In addition, prostate cancer may develop slowly so that you experience no prostate cancer symptoms before dying from other causes. Furthermore, the treatment of prostate cancer may have significant side effects.
However, the doctor would suggest you have a PSA test done 'to be safe'. You DECIDE TO HAVE a PSA test done.
Finally the doctor concludes that everything seems ok -that you are as healthy as you look, but that 'as a doctor you can of course not issue guarantees', and that you should see your doctor, 'if something new turns up and by the way, I will see you in 14 days to review your test results'.

(STEP 2 -MAIN VARIANT 3b)
Your doctor tells you about a blood test for prostate cancer. It is called PSA. PSA is a natural enzyme produced by the male prostate gland that can be measured in blood. The test is used for diagnostics and control of prostate cancer treatment. PSA blood levels normally increase with age, prostate gland enlargement, and if the prostate is sick (e.g., cancer). However, an increased PSA does not necessarily mean that you have prostate cancer. The doctor then tells you that 'it is not common' to test all for prostate cancer with PSA because the tes t is not good enough. One can for example have increased PSA in the blood without having prostate cancer. In addition, prostate cancer may develop slowly so that you experience no prostate cancer symptoms before dying from other causes. Furthermore, the treatment of prostate cancer may have significant side effects.
However, the doctor would suggest you have a PSA test done 'to be safe'. ANYWAY, you decide NOT to have a PSA test done.
Finally the doctor concludes that everything seems ok -that you are as healthy as you look, but that 'as a doctor you can of course not issue guarantees', and that you should see your doctor, 'if something new turns up and by the way, I will see you in 14 days to review your test results'.
Your doctor tells you about a blood test for prostate cancer. It is called PSA. PSA is a natural enzyme produced by the male prostate gland that can be measured in blood. The test is used for diagnostics and control of prostate cancer treatment. PSA blood levels normally increase with age, prostate gland enlargement, and if the prostate is sick (e.g., cancer). However, an increased PSA does not necessarily mean that you have prostate cancer. The doctor then tells you that 'it is not common' to test all for prostate cancer with PSA because the test is not good enough. One can for example have increased PSA in the blood without having prostate cancer. In addition, prostate cancer may develop slowly so that you experience no prostate cancer symptoms before dying from other causes. Furthermore, the treatment of prostate cancer may have significant side effects.
You DECIDE TO HAVE a PSA test done.
Finally the doctor concludes that everything seems ok -that you are as healthy as you look, but that 'as a doctor you can of course not issue guarantees', and that you should see your doctor, 'if something new turns up and by the way, I will see you in 14 days to review your test results'.

(STEP 2 -MAIN VARIANT 4b)
Your doctor tells you about a blood test for prostate cancer. It is called PSA. PSA is a natural enzyme produced by the male prostate gland that can be measured in blood. The test is used for diagnostics and control of prostate cancer treatment. PSA blood levels normally increase with age, prostate gland enlargement, and if the prostate is sick (e.g., cancer). However, an increased PSA does not necessarily mean that you have prostate cancer. The doctor then tells you that 'it is not common' to test all for prostate cancer with PSA because the test is not good enough. One can for example have increased PSA in the blood without having prostate cancer. In addition, prostate cancer may develop slowly so that you experience no prostate cancer symptoms before dying from other causes. Furthermore, the treatment of prostate cancer may have significant side effects.
You decide NOT to have a PSA test done.
Finally the doctor concludes that everything seems ok -that you are as healthy as you look, but that 'as a doctor you can of course not issue guarantees', and that you should see your doctor, 'if something new turns up and by the way, I will see you in 14 days to review your test results'.

(STEP 2 -MAIN VARIANT 5a)
Your doctor tells you about a blood test for prostate cancer. It is called PSA.
The doctor also informs you that it is a personal decision whether you want to have the test or not. Therefore, a guidance tool has been developed to help in making the decision. The tool is also publicly available from the health authorities' major web portal (Sundhed.dk). The doctor hands you the tool and invites you to go through it.
Afterwards, the doctor offers to talk to you to clarify questions etc. Finally the doctor concludes that everything seems ok -that you are as healthy as you look, but that 'as a doctor you can of course not issue guarantees', and that you should see your doctor, 'if something new turns up and by the way, I will see you in 14 days to review your test results'.

(STEP 2 -MAIN VARIANT 5b)
Your doctor tells you about a blood test for prostate cancer. It is called PSA.
The doctor also informs you that it is a personal decision whether you want to have the test or not. Therefore, a guidance tool has been developed to help making the decision. The tool is also publicly available from the health authorities' major web portal (Sundhed.dk). The doctor hands out the tool and invites you to go through it.
Afterwards, the doctor offers to talk to you to clarify questions etc. Finally the doctor concludes that everything seems ok -that you are as healthy as you look, but You subsequently have surgery aiming at totally eradicating the cancer. At first, you are informed that eradication was successful. However, you have side-effects like erectile dysfunction, urinary problems and slight fecal incontinence. Afterwards you are told that the prostate cancer is not entirely removed but unluckily has spread to other parts of the body. You receive chemo and radiation therapy but you understand that you probably will live for no more than 3 years.
You are sad and have a conversation with your family. You wonder if the cancer could have been detected at an earlier stage, if it could have been totally eradicated, or if one -given the situationwould have rather lived without knowing about the cancer.
You talk with your family about your experiences with your doctor.

(QUESTIONNAIRE PART)
You will be now asked to assess the course of health care just described Finally, we will ask you some more general questions about you: