Lincoln, Yvonna, and Egon Guba, "Postpositivism and the Naturalist Paradigm," pp. 14-46 in Yvonna Lincoln and Egon Guba, Naturalistic Inquiry . Beverly Hills, CA: Sage, 1985.*

The relationship between service quality and customer satisfaction has received considerable academic attention in the past few years. But the nature of the exact relationship between service quality and customer satisfaction (especially in the way the two constructs have been operationalized) is still shrouded with uncertainty. Many researchers have operationalized customer satisfaction by using a single item scale and many others have used multiple item scales. The present study adopts a different approach and views customer satisfaction as a multi dimensional construct just as service quality, but argues that customer satisfaction should be operationalized along the same factors (and the corresponding items) on which service quality is operationalized. Based on this approach, the link between service quality and customer satisfaction has been investigated. The results have indicated that the two constructs are indeed independent but are closely related, implying that an increase in one is likely to lead to an increase in another.

The relationship between service quality and customer satisfaction – a factor specific approach

Purpose – This paper reviews 20 years (1988‐2008) of research on the SERVQUAL scale for measuring service quality.Design/methodology/approach – A range of studies that have applied the SERVQUAL scale in this 20‐year period are examined in a non‐exhaustive review of the literature. These studies are selected from well‐known databases – such as “ABI/Inform”, “ScienceDirect”, and “EBSCOhost”.Findings – The paper identifies and summarizes numerous theoretical and empirical criticisms of the SERVQUAL scale. Despite these criticisms, the paper concludes that SERVQUAL remains a useful instrument for service‐quality research.Originality/value – The paper provides a useful source of information on SERVQUAL and its applications. In particular, the paper summarizes a selection of 30 applications of SERVQUAL.

A review of twenty years of SERVQUAL research

Background Limited resources coupled with unlimited demand for healthcare mean that decisions have to be made regarding the allocation of scarce resources across competing interventions. Policy documents have advocated the importance of public views as one such criterion. In principle, the elicitation of public values represents a big step forward. However, for the exercise to be worthwhile, useful information must be obtained that is scientifically defensible, whilst decision-makers must be able and willing to use it. Aims and objectives The aim was to identify techniques that could be reasonably used to elicit public views on the provision of healthcare. Hence, the objectives were: (1) to identify research methods with the potential to take account of public views on the delivery of healthcare; (2) to identify criteria for assessing these methods; (3) to assess the methods identified according to the predefined criteria; (4) to assess the importance of public views vis-a-vis other criteria for setting priorities, as judged by a sample of decision-makers; (5) to make recommendations regarding the use of methods and future research. Methods A systematic literature review was carried out to identify methods for eliciting public views. Criteria currently used to evaluate such methods were identified. The methods identified were then evaluated according to predefined criteria. A questionnaire-based survey assessed the relative importance of public views vis-a-vis five other criteria for setting priorities: potential health gain; evidence of clinical effectiveness; budgetary impact; equity of access and health status inequalities; and quality of service. Two techniques were used: choice-based conjoint analysis and allocation of points technique. The questionnaire was sent to 143 participants. A subsample was followed up with a telephone interview. Results The methods identified were classified as quantitative or qualitative. RESULTS - QUANTITATIVE TECHNIQUES: Quantitative techniques, classified as ranking, rating or choice-based approaches, were evaluated according to eight criteria: validity; reproducibility; internal consistency; acceptability to respondents; cost (financial and administrative); theoretical basis; whether the technique offered a constrained choice; and whether the technique provided a strength of preference measure. Regarding ranking exercises, simple ranking exercises have proved popular, but their results are of limited use. The qualitative discriminant process has not been used to date in healthcare, but may be useful. Conjoint analysis ranking exercises did well against the above criteria. A number of rating scales were identified. The visual analogue scale has proved popular within the quality-adjusted life-year paradigm, but lacks constrained choice and may not measure strength of preference. However, conjoint analysis rating scales performed well. Methods identified for eliciting attitudes include Likert scales, the semantic differential technique, and the Guttman scale. These methods provide useful information, but do not consider strength of preference or the importance of different components within a total score. Satisfaction surveys have been frequently used to elicit public opinion. Researchers should ensure that they construct sensitive techniques, despite their limited use, or else use generic techniques where validity has already been established. Service quality (SERVQUAL) appears to be a potentially useful technique and its application should be researched. Three choice-based techniques with a limited application in healthcare are measure of value, the analytical hierarchical process and the allocation of points technique, while those more widely used, and which did well against the predefined criteria, include standard gamble, time trade-off, discrete choice conjoint analysis and willingness to pay. Little methodological work is currently available on the person trade-off. RESULTS - QUALITATIVE TECHNIQUES: Qualitative techniques were classified as either individual or group-based approaches. Individual approaches included one-to-one interviews, dyadic interviews, case study analyses, the Delphi technique and complaints procedures. Group-based methods included focus groups, concept mapping, citizens' juries, consensus panels, public meetings and nominal group techniques. Six assessment criteria were identified: validity; reliability; generalisability; objectivity; acceptability to respondents; and cost. Whilst all the methods have distinct strengths and weaknesses, there is a lot of ambiguity in the literature. Whether to use individual or group methods depends on the specific topic being discussed and the people being asked, but for both it is crucial that the interviewer/moderator remains as objective as possible. The most popular and widely used such methods were one-to-one interviews and focus groups. (ABSTRACT TRUNCATED)

Eliciting public preferences for healthcare: a systematic review of techniques.

In this study, 258 volunteers in human services and 104 nonvolunteers were asked to rank in importance 28 motives for volunteering that had been identified in a thorough literature review. According to the literature, most researchers assume that motivation to volunteer (MMV) is a two-or three-dimensional phenomenon, but very few studies have carried out an empirical analysis of the internal dimensionality of MTV. The present findings indicate that when all 28 motives were subjected to various types of factor analysis, most items were grouped together on one factor. In other words, a unidimensional scale was obtained.

Measuring motivation to volunteer in human services.

This study investigates the applicability of a modified SERVQUAL instrument as a means of measuring residents' perceptions of long‐term health‐care service quality in the USA and UK. The results confirm a stable, four‐factor structure that is similar to previously defined service quality dimensions and is invariant across the countries studied.

The applicability of SERVQUAL in cross‐national measurements of health‐care quality

The aging of the population will increase demand for psychological services for older adults, which challenges the profession of psychology to provide those services. In response to that challenge, professional geropsychology has been developing over the past few decades to meet current and prepare for anticipated future demand. The development of a range of training opportunities is important to enable psychologists to work effectively with older adults. This article describes the Pikes Peak model for training in professional geropsychology. The model is an aspirational, competencies-based approach to training professional geropsychologists that allows for entry points at multiple levels of professional development.

Pikes Peak model for training in professional geropsychology.

The present study examined patterns of serious mental illness (SMI), specific mental health syndromes, and service use among older (65) and younger (18‐64) adults throughout the United States, and the extent to which various factors predict SMI and the use and magnitude of mental health treatment. Despite recent developments designed to improve mental healthcare access and treatment for older adults, older individuals were found to receive outpatient mental healthcare at very low rates. Compared to younger adults, older adults were three times less likely to report receiving treatment. Although prevalence estimates for SMI and specific syndromes were markedly lower among older than younger adults, older individuals most in need of care were highly unlikely to report receiving treatment. Findings point to the importance of perceived need in mental healthcare use. Significantly, however, those older adults that made it into services typically reported benefiting considerably from treatment, at least as much as all other age groups. Several predisposing, enabling, and need factors related to mental illness and service use were identified that have important implications for how we plan for, design, and deliver mental health services to older and younger Americans.

Patterns and predictors of mental health service use and mental illness among older and younger adults in the United States.

Families versus institutions: incongruent role expectations in the nursing home.

This article compares the service quality expectations of residents, family, and administrators within a long-term-care context. Expectations for service quality are measured using the SERVQUAL scale. The results support the reliability of the SERVQUAL instrument for nursing home residents. Resident

Michael Duffy

Papers

The applicability of SERVQUAL in cross‐national measurements of health‐care quality

Pikes Peak model for training in professional geropsychology.

Patterns and predictors of mental health service use and mental illness among older and younger adults in the United States.

Families versus institutions: incongruent role expectations in the nursing home.

A comparative study of resident, family, and administrator expectations for service quality in nursing homes.