Measuring Wellbeing in a Healthcare Setting: a Qualitative Study of Staff and Service User Perspectives

Abstract

This study explored staff and service users’ views on a selection of candidate wellbeing questionnaires for use by a UK-based healthcare provider, Nuffield Health, that is embarking on a programme to monitor the impact of their services on wellbeing. Ten stakeholder focus groups were conducted with 64 staff and service users, in addition to three in-depth telephone interviews with Nuffield Health Executive Board members. Focus groups and interviews were audio-recorded and transcripts examined using qualitative thematic analysis. Across focus groups, stakeholders commented on the importance of ensuring that data from wellbeing questionnaires provided actionable insight that can help to direct care and inform service improvements. Service users conceptualised their own wellbeing as a broad concept that encompassed more than just a mental state, and that was broadly aligned to the notion of feeling “in balance”. Following the measurement process, service users were particularly interested to receive feedback on determinants of their own wellbeing, beyond those directly related to the services provided by Nuffield Health. Staff discussed the importance of embedding wellbeing measurement within a supportive service infrastructure and ensuring that appropriate training is available to help those with distinct wellbeing-related needs if identified through the monitoring process. Wellbeing is complex and subjective concept, and existing questionnaires used by Nuffield Health are inappropriate for measuring the independent impact of a health service on user wellbeing. Further work is required to pilot test alternative questionnaires that better reflect service users’ intuitive understandings of their own wellbeing, and that can provide actionable data to inform ongoing service improvements.