Wellness Tourism Experiences and Tourists’ Satisfaction: A Multicriteria Analysis Approach

Abstract

The present study explores the determinants of tourist satisfaction within the context of wellness tourism in Greece, an emerging segment of the tourism industry that emphasizes holistic well-being. The aim was to assess the overall satisfaction of wellness tourists, identify the relative importance and performance of satisfaction dimensions, and offer insights for service improvement. A structured questionnaire was administered to 487 wellness tourists during the summer of 2024, and the data were analyzed using descriptive statistics and the Multicriteria Satisfaction Analysis (MUSA) method. The results revealed a high overall satisfaction level (90.4%), with physical and spiritual well-being activities contributing most significantly to the satisfaction structure. In contrast, mind well-being activities scored the lowest in satisfaction, despite being rated highly in importance, suggesting a service gap. Improvement analysis indicated that mental and spiritual well-being activities are high-impact, low-effort areas for enhancement. Demographic data further highlighted that wellness tourists are typically young, educated and economically active women. The findings suggest the need for more personalized, holistic offerings and point to the potential integration of wellness and medical tourism services. The study offers practical implications for wellness providers and destination managers and identifies future research directions related to satisfaction dynamics and health-oriented tourism strategies.

1. Introduction

Tourism is widely recognized as one of the most dynamic and multifaceted sectors of the global economy (Skordoulis et al., 2024a). Over the past decades, it has expanded both quantitatively and qualitatively, influencing not only economic indicators, such as gross domestic product (GDP) growth and employment, but also shaping cultural interactions, social behaviors, and individual well-being (Li et al., 2018). It transcends the traditional boundaries of leisure and recreation and increasingly serves as a platform for self-discovery, personal development, and transformative experiences. Within this broader landscape, tourism is no longer viewed solely as a passive act of consumption, but as a complex process of co-creation between hosts and guests, structured around experiences that often carry deep emotional, psychological, and even spiritual significance (Schuckert et al., 2018).

Among the various specialized forms of tourism that have gained prominence in the 21st century, wellness tourism occupies a distinctive and rapidly expanding position (Csirmaz & Pető, 2015). Rooted in the global shift toward preventive health, holistic living, and self-care, wellness tourism responds to the growing societal demand for balance in a world often characterized by stress, overwork, and urban alienation (Bardukova, 2024). As an umbrella term, wellness tourism includes travel undertaken with the primary motivation of achieving, enhancing or maintaining personal well-being. It encompasses a broad spectrum of activities and services such as spa treatments, meditation and mindfulness retreats, yoga vacations, nutrition and detox programs, fitness tourism, thermal baths and nature immersion. Furthermore, unlike medical tourism, which is typically curative and illness-driven, wellness tourism is proactive, preventive, and enhancement-oriented (Martins et al., 2025).

While the empirical setting of this study is Greece, the insights derived from the wellness tourism experience are transferable to other emerging wellness destinations that are similarly seeking to diversify their tourism offerings, extend the tourism season, and respond to shifting traveler expectations. As wellness tourism continues to grow globally, understanding the structure of tourist satisfaction in real-world settings offers both academic and managerial value for international markets.

The significance of this study becomes even more pronounced when examined in the context of Greece, a country with a well-established tourism industry but a relatively underdeveloped wellness tourism sector (Vasileiou et al., 2016). Despite Greece’s abundant natural resources, favorable climate, rich cultural heritage, and long-standing traditions related to health, healing, and holistic well-being (e.g., thermal springs, Mediterranean diet, nature-based spirituality), wellness tourism has only recently begun to emerge as a strategic development priority (Tsekouropoulos et al., 2024). In the aftermath of economic instability and under the pressure of global competition, Greek tourism stakeholders are increasingly turning toward diversification and sustainability as guiding principles for future growth (Apostolopoulos & Sonmez, 2014). In this context, wellness tourism represents a high-potential route in order to extend the tourism season, attract high-value visitors, and promote decentralized development beyond mass tourism hubs (Andreu et al., 2021).

In this study, satisfaction is conceptualized not as an outcome driven by specific antecedents such as motivations or expectations but as a multidimensional construct comprising distinct satisfaction dimensions. Rather than predicting satisfaction, the study aims to unpack its internal structure through a typological approach that identifies and evaluates multiple dimensions; physical, mental, spiritual, and environmental satisfaction. This allows for a more nuanced understanding of what shapes wellness tourists’ overall evaluations and offers practical insights into where service improvements can yield the greatest impact.

The aim of this paper is to explore and evaluate the satisfaction of tourists engaged in wellness tourism experiences, utilizing the Multicriteria Satisfaction Analysis (MUSA) method to capture the multidimensional character of their evaluations. The study seeks to answer the following questions:

• What are the primary satisfaction dimensions in wellness tourism as perceived by visitors?
• What is the relative importance and perceived performance of these dimensions?
• How can the results inform destination management and service design in wellness tourism settings?

By addressing these questions, this paper contributes to both theoretical and practical discussions in tourism research. Theoretically, it enhances our understanding of how satisfaction is formed and structured in specialized tourism contexts. Practically, it provides empirical insights that can guide stakeholders, such as wellness resort managers, tourism planners, and policymakers, in designing more effective, responsive, and value-rich experiences for wellness tourists. The results are intended not only to assess satisfaction retrospectively, but also to support proactive strategic planning and continuous service improvement in wellness destinations. Moreover, by focusing on Greece, the present study aims to offer context-specific insights while contributing to the broader international discourse on wellness tourism development in transitional markets.

2. Literature Review

2.1. Wellness Tourism: Definitions, Motivations, and Trends

The present literature review focuses on three core themes underpinning the present study: the evolution of wellness tourism, the structure and measurement of tourist satisfaction, and the application of multicriteria analysis methodologies in tourism service evaluation.

Scholars generally define wellness tourism as travel with the primary purpose of maintaining or enhancing one’s personal well-being, distinct from medical tourism, which focuses on curative treatment (Smith & Puczkó, 2014). Wellness tourism includes both passive and active components such as spa treatments, nature immersion, yoga, mindfulness retreats, detox programs, and healthy cuisine (Martins et al., 2025; Dillette et al., 2021). The Global Wellness Institute (2021) describes wellness tourism as “travel associated with the pursuit of maintaining or enhancing one’s personal well-being,” further categorizing it into primary wellness tourists (those for whom wellness is the main travel motivation) and secondary wellness tourists (those who engage in wellness activities as part of a broader trip). Wellness tourism is recognized as a significant and growing market segment, comprising activities such as spa treatments, nature retreats, mindfulness, and holistic health services.

In this study, we adopt an inclusive view of wellness tourism encompassing both physical and psychological well-being activities, emphasizing holistic experiences that support body, mind, and spirit in restorative, preventive, and transformative ways. This conceptualization draws upon the multidimensional frameworks established in prior wellness tourism studies (Y. J. Lim et al., 2016; Liao et al., 2023).

Wellness tourism is recognized as a significant and growing market segment, comprising activities such as spa treatments, nature retreats, mindfulness, and holistic health services (Dini & Pencarelli, 2022), and has emerged as one of the fastest-growing segments in the global travel industry, responding to shifting consumer values and increased attention to health, self-care, and lifestyle quality (Bardukova, 2024). Unlike traditional forms of tourism centered on leisure or sightseeing, wellness tourism is motivated by travelers’ desire to enhance or maintain their physical, mental, and emotional well-being through purposeful travel experiences. Activities range from spa treatments and thermal baths to mindfulness retreats, detox programs, and holistic therapies (Smith & Puczkó, 2014; Martins et al., 2025). The COVID-19 pandemic has further accelerated interest in wellness-related travel, particularly among younger demographics and middle-income travelers seeking preventive health strategies (He et al., 2023).

The rising interest in wellness tourism is not merely a market trend; it reflects deeper transformations in consumer values, perceptions of health, and lifestyle aspirations (Thapa et al., 2024). Within this context, wellness travelers are often more conscious, value-driven, and experience-oriented compared to traditional tourists. Their decision-making processes are influenced not only by price and convenience, but by qualitative dimensions such as authenticity, atmosphere, emotional engagement, and the promise of lasting personal benefit (He et al., 2023; Balcioglu, 2024). As such, the measurement of tourist satisfaction within this segment requires a sophisticated and context-sensitive approach.

Increasingly, wellness tourism is being framed within the broader theoretical lens of transformational tourism, which emphasizes meaningful, self-reflective experiences that lead to personal growth and lasting behavioral change (Andreu et al., 2021; Dillette et al., 2021). Rather than serving solely as a break from routine, wellness travel offers opportunities for emotional healing, identity exploration, and lifestyle recalibration. This emerging theoretical framework positions wellness tourists not as passive consumers, but as active seekers of change, and places added importance on satisfaction outcomes that are affective, spiritual, and introspective in nature. Understanding these deeper motivational drivers helps contextualize why satisfaction in this domain extends beyond functional service delivery and into the realm of perceived personal transformation.

2.2. Wellness Tourism in Greece

Greece, while long established as a global tourism destination, remains an emerging player in the wellness tourism sector. Despite its abundant natural resources including thermal springs, mountainous landscapes, and coastal environments and a rich cultural heritage emphasizing balance, diet, and healing, wellness tourism in Greece has not yet reached its full potential (Vasileiou et al., 2016; Tsekouropoulos et al., 2024). Most wellness tourism offerings in the country are currently driven by private initiatives, with limited coordination at the national level. However, recent policy developments signal a growing institutional interest. For instance, the Medium-Term Fiscal-Structural Plan 2025–2028 identifies “Health & Wellness Tourism through Thermal Springs” as a national strategic priority (Ministry of Economy and Finance, 2025).

Greece’s geography offers a diverse landscape well-suited to wellness tourism development. Mountainous regions such as Epirus, Thessaly, and Central Macedonia provide natural settings ideal for retreat-style experiences and nature immersion. Peloponnese and Crete offer rich combinations of coastal, cultural, and wellness resources, while the Cycladic islands have begun integrating high-end wellness offerings into luxury tourism.

In contrast, inland and northern areas like Thrace and Western Macedonia remain largely underdeveloped but possess untapped thermal spring resources and could support decentralized tourism strategies.

Existing wellness hubs are concentrated in Central Greece, Attica, and the Dodecanese, where spa resorts, yoga retreats, and medical–wellness hybrid services have started gaining traction. These regions benefit from better infrastructure, higher tourist arrivals, and proximity to international transport networks. However, considerable development potential exists across the mainland and islands, particularly in areas rich in natural springs, herbal biodiversity, and wellness-oriented cultural heritage.

Thus, in recent years, Greece has emerged as a growing destination for wellness tourism, capitalizing on its rich natural resources, thermal springs, and a tradition of holistic healing that spans from antiquity to modern spa science.

Existing research suggests that Greece’s competitive advantages lie in its climate, biodiversity, and long-standing traditions related to holistic health, such as the Mediterranean diet and ancient thermal bathing practices (Apostolopoulos & Sonmez, 2014; Smith & Puczkó, 2014). Nevertheless, challenges remain in developing a cohesive national wellness tourism brand and infrastructure. Many rural or lesser-known regions with natural healing resources remain underutilized, lacking both marketing support and investment in quality service delivery.

Expanding wellness tourism in Greece holds potential for addressing issues such as seasonality, over-tourism in major hubs, and rural economic development. Integrating wellness with medical tourism, as proposed by recent studies (Tsekouropoulos et al., 2024; Martins et al., 2025), could provide Greece with a dual advantage in the global health tourism landscape. Understanding visitor satisfaction in this emerging sector is therefore not only timely, but essential for evidence-based planning and investment decisions. In this evolving landscape, systematic measurement and understanding of visitor satisfaction in wellness tourism become critical to crafting strategies that leverage Greece’s inherent strengths, while ensuring long-term sustainability and economic impact (Drosos & Skordoulis, 2018).

2.3. Tourist Satisfaction in Wellness Tourism

Tourist satisfaction has long been a central concept in tourism studies and marketing research. It is commonly understood as the psychological outcome of a cognitive-affective evaluation process, in which travelers compare their expectations prior to the visit with their actual experiences. High levels of satisfaction are positively correlated with behavioral intentions such as revisit likelihood, destination loyalty, and positive word-of-mouth communication (Skordoulis et al., 2024b). Moreover, in a competitive and experience-driven tourism market, satisfaction serves as a strategic indicator for quality assessment, service improvement, and brand differentiation (Skordoulis et al., 2017; Drosos et al., 2019b).

In wellness tourism, satisfaction is influenced by more than just service efficiency—it reflects deeper, multidimensional experiences related to relaxation, emotional renewal, and personal transformation (Seow et al., 2024; Sthapit et al., 2023). Travelers’ expectations are shaped by intrinsic goals such as stress relief, health enhancement, and spiritual growth, making the measurement of satisfaction in this segment particularly complex. Empirical studies have identified key drivers of wellness tourist satisfaction, including perceived authenticity, environmental quality, emotional value, and interpersonal interactions (Dillette et al., 2021; Liu et al., 2023). Satisfaction outcomes are closely tied to behavioral intentions, such as repeat visitation, positive word-of-mouth, and destination loyalty (Skordoulis et al., 2024b).

The study of satisfaction within the framework of wellness tourism carries considerable theoretical and practical significance. On a theoretical level, it contributes to the expanding body of knowledge that recognizes tourism as a complex, multidimensional experience rather than a transactional activity. Wellness tourism, in particular, challenges conventional models of tourist behavior by emphasizing subjective well-being, emotional engagement, and lifestyle congruence (Andreu et al., 2021). As the global tourism industry undergoes a shift toward personalization and value-based offerings (Sidiq & Sahman, 2025), understanding how satisfaction is formed in niche markets like wellness tourism becomes essential. Furthermore, from a managerial standpoint, the ability to identify which aspects of the wellness experience influence visitor satisfaction the most, enables providers to strategically allocate resources, improve service quality, and enhance their competitive positioning (Grigoroudis & Siskos, 2002). In a highly competitive global environment, where destinations increasingly market themselves through experiential differentiation, a deep understanding of satisfaction drivers can inform branding, product development, and customer retention strategies.

Quantitative evidence from international contexts provides robust benchmarks for understanding satisfaction in wellness tourism. Y. J. Lim et al. (2016) found that 85% of repeat visitors to Korean wellness resorts reported satisfaction levels above 4.2 on a 5-point scale. In a Malaysian context, Seow et al. (2024) found that tourists’ perceived emotional value and authenticity were the most significant predictors of revisit intention. Similarly, Liu et al. (2023) demonstrated that in China, satisfaction with esthetic and escape experiences directly contributed to both hedonic and eudaimonic well-being. In South Korea, Jeong (2024) emphasized the role of restorative environments and perceived privacy in shaping satisfaction levels among wellness tourists. In Andalusia, a population-weighted survey of 725 spa users reported 92.4% intention to recommend and 63.6% intention to return the following year; reliability testing also showed substantial test–retest agreement across satisfaction items, underscoring the robustness of the instrument (Anaya-Aguilar et al., 2021b). A companion segmentation study on the same regional market identified three satisfaction clusters, with the high-satisfaction segment comprising 58% of respondents, reinforcing the predominance of positive evaluations in mature European spa contexts (Anaya-Aguilar et al., 2021a).

Moving from descriptives to structural models, Campón-Cerro et al. (2020) analyzed 184 thermal-spa customers using PLS-SEM and reported that the model explained 51.9% of variance in experience satisfaction, 46.0% in quality of life, 67.1% in experience loyalty, and 64.7% in destination loyalty. The experience—satisfaction path was strong (β = 0.720), and satisfaction played a central role in downstream loyalty outcomes, specifically referring to experience loyalty and destination loyalty.

Large-scale text-as-data corroborates these patterns outside Europe. An analysis of 24,060 Google reviews from 11 Korean wellness destinations combined semantic-network methods with linear regression, finding that the “wellness” factor had the highest positive beta on satisfaction, while value, food and beverage, and service emerged as negative predictors—pinpointing concrete operational levers for managers at scale (Riswanto & Kim, 2023). Complementing this, a survey-based SEM with 445 Chinese wellness tourists showed that tourist satisfaction mediates the effect of entertainment, esthetic, escape experiences on hedonic and eudaimonic well-being, with gender and age moderating several paths—evidence that satisfaction functions as an intervening mechanism across cultures and age cohorts (Liu et al., 2023).

Finally, Ahn and Kim (2024) modeled the behavioral chain from experience to loyalty using SEM with 319 Korean wellness tourists. The study reported that experiential engagement strongly predicted satisfaction (β = 0.647), which in turn strongly predicted destination loyalty (β = 0.756). The model explained 55.7% of the variance in satisfaction and an impressive 81.1% of the variance in loyalty. Indirect effects also confirmed that wellness motivation influenced loyalty primarily through engagement and satisfaction, validating a robust engagement—satisfaction—loyalty chain. Together, these findings confirm that satisfaction not only captures the emotional and cognitive evaluation of wellness experiences, but also reliably predicts key behavioral outcomes—such as intention to return, recommend, and associate personal well-being with the tourism product.

The above studies illustrate that while wellness tourism is influenced by cultural and contextual factors, the underlying satisfaction dimensions show broad international relevance. These quantitative findings reinforce the need to measure not only overall satisfaction, but also the relative contribution of different satisfaction dimensions. Moreover, taken together, these multi-country, multi-method converge on a quantitative narrative: experience quality and engagement reliably elevate satisfaction, which in turn strongly predicts revisit and loyalty.

2.4. Multicriteria Satisfaction Analysis in Wellness Tourism

However, for initiatives like the above ones to be successful, a clear understanding of visitors’ expectations and satisfaction determinants is critical. By applying a systematic, multicriteria-based satisfaction analysis, this study offers valuable insights that can support the design and delivery of authentic, high-quality wellness experiences tailored to the needs of both domestic and international visitors.

Moreover, the construct of satisfaction is inherently multifactorial and multidimensional (Grigoroudis & Siskos, 2002; C. Lim et al., 2019). Especially in the context of wellness tourism, where services are often intangible, personalized, and deeply experiential, satisfaction cannot be accurately captured through unidimensional or overly simplified methods (Pantouvakis & Bouranta, 2013). Factors such as emotional resonance, interpersonal interaction, spiritual fulfillment, perceived value, and alignment with personal goals, all contribute to a complex evaluative framework that goes beyond traditional satisfaction metrics. Therefore, measuring satisfaction in wellness tourism demands analytical tools capable of disentangling the relative weight and performance of multiple criteria simultaneously.

In response to this methodological challenge, the present study employs the Multicriteria Satisfaction Analysis (MUSA) model, a decision-support methodology based on the principles of multicriteria decision analysis. MUSA is designed to assess customer satisfaction by simultaneously considering the importance and perceived performance of various satisfaction criteria (Grigoroudis & Siskos, 2002). Unlike conventional statistical approaches that may treat satisfaction as a uniform construct, MUSA acknowledges the heterogeneity of customer preferences and the trade-offs that consumers make when evaluating service experiences. The model produces quantitative outputs, including global and partial satisfaction indices, performance-importance diagrams, and action diagrams, offering a rich and nuanced understanding of the satisfaction structure (Grigoroudis & Siskos, 2002).

To address the multidimensional nature of satisfaction, several researchers have already adopted multicriteria decision analysis (MCDA) methods that can simultaneously assess multiple satisfaction attributes. The Multicriteria Satisfaction Analysis (MUSA) model has been applied in various service sectors for its ability to integrate performance and importance ratings across several criteria (Grigoroudis & Siskos, 2002). In tourism research, MUSA has been successfully used to evaluate service quality in public services (Skordoulis et al., 2017) and environmental satisfaction in hospitality contexts (Drosos et al., 2019a). Unlike traditional statistical methods, MUSA allows for the construction of global and partial satisfaction indices and provides actionable managerial insights through action and improvement diagrams. Given the experiential and subjective nature of wellness tourism, MUSA offers a particularly valuable analytical framework for understanding which aspects of the service most significantly influence tourist satisfaction.

While other multicriteria models such as the Analytic Hierarchy Process (AHP) and the SERVQUAL framework have been widely applied in tourism and hospitality studies, each presents distinct limitations in capturing the complexity of experiential satisfaction. AHP is effective for prioritizing hierarchical decision criteria but often relies on expert judgment rather than actual customer evaluations, limiting its applicability in service satisfaction studies. SERVQUAL, on the other hand, measures the gap between expected and perceived service quality across fixed dimensions, which may not capture the full spectrum of wellness experiences (Pantouvakis & Bouranta, 2013). MUSA is uniquely positioned in this context as it integrates customer-generated data to produce both global and partial satisfaction indices, and accounts for both perceived importance and performance. This allows for a more nuanced and flexible analysis, particularly in tourism segments where subjective well-being is a key outcome.

Thus, applying the MUSA model to wellness tourism allows us to identify which aspects of the experience matter to visitors the most, how well each aspect performs according to their perceptions, and where service improvements can generate the highest marginal benefit in overall satisfaction. This is particularly valuable in a field such as wellness tourism, where customer expectations are elevated, and the differentiation of service offerings is often subtle but decisive.

This study adopts a structural perspective by treating satisfaction as a composite construct composed of inter-related but distinct dimensions. Following this approach, the analysis does not attempt to identify external antecedents or predictors of satisfaction. Instead, it focuses on understanding the internal composition of satisfaction by analyzing the relative importance and performance of each dimension. This typological orientation is consistent with multicriteria evaluation frameworks and offers valuable insights for both theory development and service optimization.

Last, this study builds on the expanding theoretical discourse that frames wellness tourism not only as a consumption-driven activity but also as a multidimensional experience rooted in psychological, emotional, and transformative outcomes. By applying a multicriteria satisfaction lens to wellness tourism, the study contributes to a growing body of literature that seeks to unpack how value is constructed and evaluated in experience-based tourism settings. These theoretical insights hold relevance across different cultural contexts and are particularly pertinent in understanding tourism motivations in an era increasingly defined by personalization and self-care.

2.5. Conceptual Framework

Building on the literature that positions wellness tourism experiences as inherently holistic and multidimensional (Dillette et al., 2021; Liao et al., 2023; Liu et al., 2023), we synthesize prior findings into a four-dimension typology of satisfaction, physical, mental, spiritual, and environmental, as shown in Figure 1.

This typology reflects the consistent clustering of wellness outcomes across studies (Smith & Puczkó, 2014; Y. J. Lim et al., 2016; Seow et al., 2024; Jeong, 2024). The resulting criteria tree (Figure 1) organizes these criteria and their sub-criteria to measurement and analysis based on the MUSA method requirements.

More specifically, the selection of the above-mentioned criteria is based on a thorough review of recent empirical research in the field of wellness tourism. Several studies have emphasized the multifactorial nature of visitor satisfaction in wellness contexts, highlighting that it is influenced not only by functional service attributes, but also by psychological, emotional, and motivational factors.

For instance, Y. J. Lim et al. (2016) identified core motivational and satisfaction-related components such as relaxation, physical revitalization, and facility quality, noting dis-tinct differences in expectations between first-time and repeat visitors.

Similarly, Lee and Kim (2023) emphasized the importance of motivation-based seg-mentation, showing that satisfaction is closely tied to how well specific needs, such as stress relief, health improvement, and emotional fulfillment, are addressed by the well-ness offering.

In a recent study, Seow et al. (2024) investigated the satisfaction of wellness tourists through a multidimensional lens, identifying several key factors that contribute to overall satisfaction and revisit intention. Among the primary satisfaction criteria examined were emotional value, referring to the psychological benefits and stress relief gained from the experience; social value, which captures the interpersonal and group-related benefits as-sociated with wellness activities; and service quality, encompassing the professionalism of staff, the quality of facilities, and the overall ambiance of the environment. Additionally, the study emphasized the importance of reward-based benefits, such as loyalty incentives or value-added services, which enhanced the perceived value of the wellness experience.

A comprehensive systematic review identified four core dimensions of wellness, including physical fitness, psychological fitness, quality of life, and environmental health, which serve as foundational constructs in understanding holistic well-being in tourism settings (Liao et al., 2023).

Empirical research reinforces the above framework; Liu et al. (2023) found that entertainment, esthetic, and escape experiences significantly enhance both hedonic and eudaimonic well-being through satisfaction.

Complementarily, qualitative research based on netnographic analysis of tourists’ online reviews also revealed that wellness experiences are consistently shaped by body, mind, spirit, and environment dimensions (Dillette et al., 2021).

Further quantitative studies emphasize that the perception of the environmental context, including ambiance, privacy, and crowding avoidance, significantly influences tourists’ satisfaction levels and revisit intentions (Jeong, 2024).

Finally, the satisfaction criteria and sub-criteria are defined as follows:

• Physical wellness activities: provided meals; physically engaging wellness activities; physically non-engaging wellness activities; activities supporting body detoxification.
• Mental wellness activities: activities that stimulate cognitive development; activities that promote mind escape and restoration from everyday thoughts.
• Spiritual wellness activities: spiritually meaningful experiences; shared experiences among visitors; experiences involving deep engagement or personal immersion in a specific activity or setting.
• Environmental factors: staff; location; price; private spaces; shared/public spaces; privacy and avoidance of overcrowding.

3. Materials and Methods

3.1. Data and Research Tool

The aim of this study is to assess the satisfaction of tourists who engaged in wellness tourism activities in Greece using the Multicriteria Satisfaction Analysis (MUSA) method. To achieve this, a quantitative research design was employed, combining descriptive statistical analysis with the application of MUSA to explore the multidimensional structure of visitor satisfaction. The research aimed not only to measure overall satisfaction, but also to identify the most influential satisfaction criteria and evaluate their relative performance and importance.

Data were collected through a structured questionnaire administered to wellness tourists in Greece from 1 July to 1 December 2024. The questionnaire was distributed in online form at selected hotels with wellness facilities. A total of 487 valid responses were obtained.

To ensure clarity and consistency in respondent understanding, a working definition of wellness tourism was presented at the beginning of the questionnaire. The definition used was: “Wellness tourism refers to travel experiences primarily aimed at improving or maintaining physical, mental, or emotional well-being through activities such as spa treatments, meditation, yoga, healthy eating, nature immersion, and other practices that support a healthy lifestyle”. This definition was adapted from established sources (Smith & Puczkó, 2014; Global Wellness Institute, 2021) and pilot-tested for clarity with a group of 20 wellness tourists prior to full data collection.

A non-probability purposive sampling technique was employed to ensure that all participants had engaged in wellness-related tourism activities during their trip. This approach was selected due to the absence of centralized databases or official registries of wellness tourists in Greece, which makes random sampling unfeasible. Participants were recruited through partnerships with selected hotels and resorts offering wellness services, including spas, yoga retreats, and nature-therapy programs. Additionally, an online version of the questionnaire was promoted through wellness tourism forums and social media platforms targeted at travelers interested in holistic wellness. While convenience sampling limits statistical generalizability, it is a widely accepted approach in exploratory tourism research, particularly when studying niche or emerging markets (Teeroovengadum & Nunkoo, 2018). This method allowed access to a targeted and relevant sample, providing valuable empirical insights into actual visitor experiences.

The research instrument was a closed-ended questionnaire comprising sections related to the demographic profiles of the respondents, the travel characteristics and the wellness tourists’ satisfaction evaluation, where participants rated their perceived satisfaction across multiple dimensions. A Likert-type scale ranging from 1 (very dissatisfied) to 5 (very satisfied) was used for all satisfaction-related items. The questionnaire was administered in Greek, since the research concerned only Greek wellness tourists. The structured questionnaire consisted of four sections:

• Demographics (e.g., age, gender, education, employment, income);
• Travel characteristics (e.g., trip duration, purpose, participation frequency);
• Satisfaction evaluation, comprising 15 Likert-scale sub-criteria organized under four key criteria (physical, mental, spiritual, environmental);
• Overall satisfaction score, rated on a 5-point scale.

All satisfaction-related criteria were mapped to the dimensions outlined in the satisfaction criteria tree (Figure 1). The structure ensured alignment with the MUSA model’s requirement for partial satisfaction criteria.

The collected data were analyzed using descriptive statistics and inferential statistics including the MUSA method.

To minimize potential sources of error and ensure the reliability of the findings, several methodological precautions were taken. First, a pilot testing of the questionnaire was conducted with a sample of 20 wellness tourists to refine item clarity and structure. Clear definitions of “wellness tourism” and related services were provided at the beginning of the questionnaire to prevent respondent misclassification. Consistency checks were performed during data entry and cleaning to identify and eliminate outliers or illogical responses. Last, the use of a multicriteria model allowed for a more robust and comprehensive measurement of satisfaction, reducing the limitations of unidimensional satisfaction scales.

The research was conducted in accordance with ethical standards. All participants were informed about the purpose of the study and participated voluntarily. Informed consent was obtained from all participants, who were clearly informed about the purpose, voluntary nature, and anonymity of their participation prior to completing the questionnaire. Prior to completing the questionnaire, respondents were assured of the anonymity and confidentiality of their responses. No personally identifiable information was collected.

3.2. MUSA Method Application

3.2.1. Overview of the MUSA Method

The MUSA method is a methodological framework rooted in multicriteria preference disaggregation. Its core premise is that overall customer satisfaction arises from multiple distinct satisfaction dimensions. The goal of the method is to integrate individual customer evaluations into a collective value function that reflects global satisfaction as accurately as possible. MUSA operates on the basis of ordinal regression, ensuring that the resulting satisfaction estimates align closely with the preferences expressed by customers.

More specifically, MUSA constructs an additive collective value function, which is denoted as Y* alongside a set of partial satisfaction functions ${\mathrm{X}}_{\mathrm{i}}^{\mathrm{*}}$, based on observed values of overall satisfaction Y and the satisfaction levels of each individual criterion X_i. The central aim is to find the best-fitting relationship between Y* and the actual satisfaction judgments Y. This is achieved by solving the following ordinal regression formulation:

$$\left\{\begin{array}{c}{\mathrm{Y}}^{\mathrm{*}}={\displaystyle \sum _{\mathrm{i}=1}^{\mathrm{n}}}{\mathrm{b}}_{\mathrm{i}}{\mathrm{X}}_{\mathrm{i}}^{\mathrm{*}}\\ {\displaystyle \sum _{\mathrm{i}=1}^{\mathrm{n}}}{\mathrm{b}}_{\mathrm{i}}=1\end{array}\right.$$

(1)

Here, Y* represents the estimated overall satisfaction, n is the number of satisfaction criteria, and b_i denotes the weight assigned to the i-th criterion, reflecting its relative importance.

To address issues related to the model’s stability, MUSA incorporates an optimality analysis step. The final solution is derived by examining a polyhedron of near-optimal solutions using a series of linear programming problems structured as follows:

$$\left\{\begin{array}{c}\left[\mathrm{m}\mathrm{a}\mathrm{x}\right]{\mathrm{F}}^{\prime }={\displaystyle \sum _{\mathrm{k}=1}^{{\mathrm{a}}_{\mathrm{i}}-1}}{\mathrm{w}}_{\mathrm{i}\mathrm{k}}\mathsf{\gamma }\mathsf{\iota }\mathsf{\alpha }\mathrm{i}=\mathrm{1,2},\dots ,\mathrm{n}\\ \mathrm{u}\mathrm{n}\mathrm{d}\mathrm{e}\mathrm{r} \mathrm{t}\mathrm{h}\mathrm{e} \mathrm{c}\mathrm{o}\mathrm{n}\mathrm{s}\mathrm{t}\mathrm{r}\mathrm{a}\mathrm{i}\mathrm{n}\mathrm{t}\mathrm{s}:\\ \mathrm{F}\le {\mathrm{F}}^{\mathrm{*}}+\mathsf{\epsilon }\end{array}\right.$$

(2)

In this model, ε is a small margin of F*, representing the allowable deviation from the optimal solution. The average outcome across all linear programming problems can be used as the final solution. However, if the model exhibits instability, this average becomes less reliable.

Moreover, MUSA offers a performance assessment framework that evaluates both global and partial satisfaction indices. These indices are computed based on the frequency distribution of customer responses across different satisfaction levels, using the following equations:

$$\mathrm{S}=\sum _{\mathrm{m}=1}^{\mathrm{a}}{\mathrm{p}}^{\mathrm{m}}{\mathrm{y}}^{\mathrm{*}\mathrm{m}} \mathrm{a}\mathrm{n}\mathrm{d} {\mathrm{S}}_{\mathrm{i}}=\sum _{\mathrm{k}=1}^{{\mathrm{a}}_{\mathrm{i}}}{\mathrm{p}}_{\mathrm{i}}^{\mathrm{k}}{\mathrm{x}}_{\mathrm{i}}^{\mathrm{*}\mathrm{k}}$$

(3)

where S and S_i are the average global and partial satisfaction indices, respectively, and p^m and ${\mathrm{p}}_{\mathrm{i}}^{\mathrm{k}}$ represent the relative frequencies of customers within the global and criterion-specific satisfaction categories y^m and ${\mathrm{x}}_{\mathrm{i}}^{\mathrm{*}\mathrm{k}}$.

The above formulas are based on the original formulation by Grigoroudis and Siskos (2002), who introduced the MUSA method for multicriteria preference disaggregation in customer satisfaction analysis.

Thus, the selection of the MUSA method over other satisfaction measurement approaches was guided by both theoretical and practical considerations. Traditional statistical techniques, such single-criterion regression models, often fail to capture the multidimensional and subjective nature of customer satisfaction (Drosos et al., 2019a), particularly in experiential contexts like wellness tourism. These approaches typically treat satisfaction as a unidimensional construct, neglecting the relative importance of different criteria as perceived by customers. In contrast, MUSA allows for a simultaneous evaluation of multiple satisfaction dimensions by producing not only a global satisfaction index, but also partial indices for each criterion, enabling a more nuanced understanding of customer priorities and service quality gaps. Furthermore, its ability to visualize results through action diagrams and priority maps makes it a highly effective tool for strategic decision-making in complex service environments.

3.2.2. Methodological Application of the MUSA Method

Guided by the literature-derived typology in the relevant analysis and Figure 1, we operationalized each satisfaction dimension as a set of criteria and sub-criteria in the questionnaire (5-point Likert scale).

Item wording followed prior scales and descriptors reported in wellness tourism studies (e.g., Y. J. Lim et al., 2016; Dillette et al., 2021; Liao et al., 2023; Seow et al., 2024) and was refined through pilot testing (n = 20) for clarity and content. In the MUSA model, these blocks define the partial satisfaction functions ${\mathrm{X}}_{\mathrm{i}}^{\mathrm{*}}$ corresponding to each dimension, which aggregate into the global satisfaction function Y* via ordinal regression.

This alignment ensures that the estimated importance weights b_i and performance indices directly reflect the theoretically specified facets of satisfaction. As MUSA is not a hypothesis-testing method but an ordinal regression-based preference disaggregation model, the study structure is built around exploratory research questions rather than research hypotheses.

4. Results

4.1. Sample Demographics

The sample demographics are presented in

Table 1. Sample demographics.

Variable	Category	% Percent
Gender	Male	31.48
	Female	68.52
Age group	18–35	43.2
	36–45	22.2
	46–55	26.5
	56–65	7.4
	Over 65	0.6
Annual income	Less than 10,000€	25.9
	10,001€–20,000€	44.4
	20,001€–30,000€	19.1
	30,001€–40,000€	3.7
	More than 40,000€	6.8
Profession	Unemployed	3.09
	Public sector	25.31
	Private sector	44.44
	Self-employed/entrepreneur	13.58
	Retired	1.28
	Student	12.35
Educational level	Secondary education	4.32
	Associate’s degree	15.43
	Bachelor’s degree	50
	Master’s degree	25.31
	Doctorate degree	4.94

Source: Authors’ own elaboration.

. The majority of participants were women (68.52%). In terms of age, the largest proportion of respondents (43.2%) belonged to the 18–35 age group, while an overwhelming 91.9% were aged 55 or younger. In terms of income, the most represented group earned between €10,001 and €20,000 annually. Regarding employment status, the majority were private-sector employees (44.44%), followed by public-sector workers (25.31%) and entrepreneurs/self-employed individuals (13.58%). Very few respondents were not employed (3.09%). Finally, in terms of educational background, 50% held a university degree and 25.31% had completed postgraduate studies, underscoring a highly educated target group.

While these demographic characteristics offer valuable insight into the profile of the surveyed group, they should be interpreted as indicative rather than representative of the broader wellness tourism market in Greece or internationally due to the non-probability sampling method employed.

4.2. Participation in Wellness Tourism Activities

The results presented in Figure 2 suggest that wellness tourism currently holds moderate appeal, with most participants engaging in such experiences on an occasional basis.

4.3. Satisfaction Measurement

The following section presents the results of the satisfaction analysis, as measured through the MUSA method, offering a detailed examination of both the global satisfaction level and the performance of individual satisfaction criteria and sub-criteria.

The global satisfaction function derived from the MUSA are presented in Figure 3. Based on the data, the overall satisfaction level of wellness tourists who participated in the study is notably high, reaching 90.4%, which indicates a strong positive evaluation of their overall experience.

As illustrated in Figure 4, the highest satisfaction level is associated with activities contributing to physical wellness, scoring 90.93%. In contrast, the lowest satisfaction level is observed in activities related to mental wellness, which received a notably lower score of 77.71%.

With regard to the extent to which wellness tourists demonstrate demanding behavior, the data presented in Figure 5 indicate that their overall level of demand is relatively low. More specifically, the criterion with the highest degree of demand pertains to activities that contribute to mental wellness, followed closely by the environment in which the wellness tourism experience is delivered.

The next part of the analysis focuses on the relative importance of each criterion in shaping overall tourist satisfaction.

According to the weight values presented in Figure 6, the most influential criterion is activities that enhance spiritual wellness, accounting for 36.22% of the overall satisfaction structure.

The final stage of the satisfaction analysis focuses on the interpretation of the action and improvement diagrams produced through the MUSA method.

Figure 7 maps satisfaction dimensions based on their current performance and importance. According to this, the criteria related to the environment and activities contributing to mental wellness fall within the status quo area. Based on the MUSA theory, no additional managerial action is required for these criteria, as they are perceived by tourists as relatively less important in shaping overall satisfaction, despite their current levels of performance.

In contrast, the other two satisfaction criteria, namely activities related to physical wellness and activities that enhance spiritual wellness, are positioned in the leverage area of the diagram. These criteria are characterized by high performance and high importance, and thus represent key strengths of wellness tourism services. They constitute the main drivers of satisfaction and can be seen as the distinctive features that set wellness tourism apart from other forms of travel.

Action diagrams are useful in identifying which satisfaction criteria require managerial attention, yet they do not provide insights into the potential outcome of improvement efforts nor do they indicate the level of effort needed to achieve the desired enhancement. This limitation is addressed through the use of improvement diagrams, which offer a more strategic framework for prioritizing actions.

Figure 8 identifies priority areas for improvement based on impact and effort. According to this, the criteria related to mental wellness activities and spiritual wellness activities fall within the first-priority area, indicating that these dimensions are both highly effective and require minimal effort to maintain or further improve.

Meanwhile, the criteria related to the environment and physical well-being activities are located in the second-priority area. These elements also require minimal effort to maintain their current satisfaction levels; however, their impact on overall satisfaction is comparatively lower than that of the first-priority criteria. Therefore, while they should not be neglected, they may not constitute the most effective focal points for immediate service enhancement strategies.

5. Discussion and Conclusions

5.1. Discussion

In the context of wellness tourism, analyzing demographic characteristics is particularly important, since factors like age, gender, income, education, and lifestyle habits significantly influence travelers’ wellness motivations, expectations, and satisfaction levels. Understanding the profile of wellness tourists allows providers to design more targeted, personalized, and effective wellness experiences that align with the specific needs of distinct demographic groups.

More specifically, referring to the research questions, the analysis confirmed four distinct dimensions of wellness tourist satisfaction identified through literature synthesis and operationalized in the MUSA criteria tree. These dimensions were clearly recognized and evaluated by the respondents, affirming the conceptual model’s relevance in the Greek wellness context.

The MUSA model results showed that mental wellness activities contributed the most to global satisfaction (36.22%), followed by physical wellness and environmental factors (17.50%). In terms of satisfaction levels, physical wellness activities scored highest (90.93%). This divergence between importance and performance indicates strategic service gaps, especially for mental and spiritual dimensions.

Moreover, the MUSA improvement diagram identified mental and spiritual wellness activities as top priorities for managerial attention, offering high impact relative to implementation effort. These findings provide clear guidance for experience designers and policymakers: enhancing programs related to cognitive restoration, meaningful engagement, and emotional connection could significantly improve perceived value and revisit intention. This aligns with prior research highlighting wellness travelers’ demand for deeper, personalized, and emotionally resonant services.

In sum, the study answers the three guiding research questions by revealing the multidimensional structure of wellness tourist satisfaction, highlighting disparities between perceived importance and performance, and identifying actionable priorities for service improvement. These findings provide both empirical evidence and practical direction for the development of wellness tourism offerings in Greece and comparable emerging destinations.

The demographic profile of the sample reveals patterns that are consistent with broader international findings; however, these findings should be interpreted cautiously given the non-representative nature of the sampling. The results are best understood as a descriptive snapshot of the specific participant group surveyed, rather than as definitive indicators of wellness tourist demographics in Greece or elsewhere.

More specifically, the fact that most of the participants were women confirms the findings of previous studies held in the field of wellness tourism and is attributed to women’s heightened awareness and responsiveness to health and well-being issues (Smith & Puczkó, 2014). Furthermore, the results of the present study indicate that wellness tourism in Greece is especially appealing to younger and middle-aged adults, an observation aligned with studies indicating that wellness tourism attracts younger demographic groups, interested in proactive lifestyle choices and preventive health strategies. In terms of income, the findings of the present study indicate that wellness tourism is not exclusively reserved for high-income individuals. Rather, it appeals to a growing middle-income segment that actively seeks meaningful health-related travel experiences. This observation is supported by broader market trends showing global expansion in the wellness sector, driven by the rising middle class and the globally increased health consciousness (Allied Market Research, 2020). In general, the findings are in line with international evidence suggesting that wellness tourists are generally more health-conscious, experience-oriented, and inclined toward preventive care and self-development (Smith & Puczkó, 2014; Y. J. Lim et al., 2016). However, while the sample skewed toward younger and female participants, the findings offer valuable insight into the satisfaction structure of active wellness tourists in Greece.

The present study also examined the frequency of participation in wellness tourism activities, as repeat visitation is a critical indicator of sustained satisfaction, perceived value, and the establishment of behavioral loyalty. Such factors are essential for the long-term viability of the wellness tourism services (Seow et al., 2024). The relatively low frequency of participation may reflect several underlying factors, including limited accessibility, economic constraints or a general lack of awareness regarding the benefits of wellness tourism. As noted by Chen et al. (2024), travelers with limited knowledge of wellness opportunities are often reluctant to integrate such experiences into their travel routines, resulting in sporadic participation. Furthermore, Hall (2011) highlights that the absence of specialized marketing strategies within the wellness tourism sector may also contribute to low visitor engagement and retention. Finally, similar findings have been reported by Chen et al. (2024), who emphasizes the importance of targeted informational campaigns in raising awareness and stimulating demand.

The finding regarding the relative importance of each criterion in shaping the overall tourist satisfaction aligns with the growing recognition of mental health and inner harmony as fundamental dimensions of the wellness tourism experience. Existing literature supports this perspective, indicating that activities such as meditation, yoga, and aromatherapy significantly enhance visitor satisfaction by promoting deep relaxation and emotional relief (Sthapit et al., 2023). Moreover, the prioritization of spiritual wellness reflects a broader shift in wellness tourism, whereby travelers increasingly seek holistic experiences that go beyond physical rejuvenation to encompass psychological and emotional balance. The high weight attributed to spiritually enriching activities reinforces the importance of personalized and high-quality experiences in wellness tourism design and delivery (Liu et al., 2023).

Regarding the findings of the final stage of the satisfaction analysis, which focuses on the interpretation of the action diagrams produced through the MUSA method, they confirm that the balance between body and spirit lies at the heart of the wellness tourism experience, emphasizing the value of integrative offerings that address both physical and emotional dimensions of wellness. Finally, regarding the findings of the final stage of the satisfaction analysis, which focuses on the interpretation of the improvement diagrams produced through the MUSA method, wellness tourism providers should continue to emphasize these two areas, as they contribute significantly to overall satisfaction, exhibit high performance levels, and can be sustained or enhanced with relatively low resource investment.

5.2. Conclusions

The findings of this study provide meaningful insights into the satisfaction structure of wellness tourists in Greece and contribute to the growing academic discourse on wellness tourism as a multidimensional, experience-based service domain. Drawing upon a robust empirical foundation and the application of the Multicriteria Satisfaction Analysis (MUSA) method, this research identifies key dimensions of satisfaction, evaluates their relative importance and performance, and offers actionable recommendations for enhancing wellness tourism offerings.

The analysis of the surveyed wellness tourists’ demographic characteristics suggests a profile of educated, economically active, predominantly female, and relatively young individuals; however, this profile should not be assumed to generalize beyond the specific sample studied. This group is likely to have specific expectations regarding wellness services, including demands for personalized, innovative, and high-quality offerings. Their consumption behavior has the potential to shape wellness tourism trends, prompting providers to adapt their services to meet the increasingly sophisticated consumer needs. This aligns with previous research suggesting that younger and female travelers often show heightened interest in wellness experiences; however, further research is needed to explore demographic-specific satisfaction drivers.

The findings of the present study regarding the participation frequency in wellness tourism activities emphasize the importance of strategic awareness campaigns and targeted informational initiatives aimed at educating potential tourists about the value and accessibility of wellness tourism. Leveraging data-driven outreach can help stimulate interest and increase repeat visitation. Additionally, the development of affordable and customizable wellness offerings could enhance participation frequency and establish wellness tourism as a regular travel choice among a broader demographic of travelers.

The exceptionally high level of overall satisfaction (90.4%) reflects a strong alignment between tourist expectations and the actual wellness experiences provided. Among the four primary dimensions assessed, physical wellness activities and spiritual wellness activities emerged as the strongest contributors to global satisfaction, both in terms of perceived quality and importance.

Interestingly, mental wellness activities received the lowest satisfaction score (77.71%), while simultaneously they were identified as the criterion with the highest level of tourist demand. This paradox suggests a critical service gap: while mental rejuvenation is valued high by wellness tourists, the offerings in this domain may not meet their expectations in terms of depth, variety, or personalization. This finding is consistent with recent literature highlighting the evolving role of mental wellness in tourism, particularly in post-pandemic contexts where stress, burnout, and emotional fatigue are on the rise (Seow et al., 2024; Lee & Kim, 2023).

Moreover, the high significance attributed to spiritual wellness activities aligns with a broader trend in wellness tourism: the search for meaningful, immersive, and transformative experiences (Dillette et al., 2021). This trend resonates with the rise of what is often termed “transformational tourism,” where individuals travel not merely for relaxation, but for deep self-reflection, personal growth, and lifestyle recalibration (Andreu et al., 2021).

In conclusion, this study confirms that wellness tourist satisfaction is multidimensional and can be effectively analyzed using a multicriteria approach. By applying the MUSA method, we identified critical satisfaction dimensions that require strategic enhancement.

5.3. Managerial and Social Implications

The results of this study have direct implications for wellness tourism providers, destination managers, and policymakers. First, resources should be strategically allocated toward enhancing activities related to mental and spiritual wellness, particularly those with high effectiveness and low improvement cost, as identified in the improvement diagram. These may include guided meditation, mindfulness workshops, and nature-immersion therapies, all of which have been empirically shown to enhance wellness outcomes (Liao et al., 2023).

Second, personalization emerges as a satisfaction key driver. Given the diversity in wellness motivations, service providers should consider offering modular or customizable wellness packages tailored to different tourist profiles (Y. J. Lim et al., 2016). Additionally, leveraging digital platforms to deliver pre-trip orientation, virtual consultations, and wellness tracking could improve service alignment with individual needs.

Socially, wellness tourism can act as a catalyst for community development and cultural revitalization, especially in rural or less-visited regions. When grounded in local traditions, such as Greek thermal healing practices or Mediterranean diet-based detox programs, it not only enriches the tourist experience, but also supports the preservation of intangible cultural heritage and promotes regional identity (Tsekouropoulos et al., 2024).

The convergence between wellness tourism and medical tourism deserves particular attention. The emphasis on physical and mental health in wellness tourism can serve as an entry point for more specialized medical travel, particularly in domains such as preventive screenings, physiotherapy, post-operative rehabilitation, or chronic disease management (Smith & Puczkó, 2015). As noted by Hall (2011), when positioned within a continuum of care, wellness tourism can increase awareness and demand for medical services among international visitors.

Greece, with its wealth of natural therapeutic resources and growing health infrastructure, is well-positioned to capitalize on this intersection. By integrating wellness and medical offerings, such as combining spa therapy with medical diagnostics or offering wellness retreats with access to healthcare professionals, providers can create hybrid packages that meet both experiential and clinical needs. Evidence suggests that tourists are increasingly receptive to such integrative models, especially in regions where the healthcare system is perceived as reliable and the cost–benefit ratio is favorable (Tsekouropoulos et al., 2024; Martins et al., 2025).

Although the findings are grounded in the Greek context, the insights regarding satisfaction priorities and service gaps are relevant to wellness tourism providers operating in comparable destinations. Regions with similar socio-economic profiles, tourism development stages, or wellness infrastructure can benefit from these findings when designing or enhancing wellness offerings.

5.4. Limitations and Future Research Directions

While this study provides robust empirical insights, certain limitations must be acknowledged. First, the use of non-probability sampling limits the generalizability of the results beyond the studied population. However, while the use of non-probability purposive sampling limits the statistical generalizability of findings, it was appropriate given the niche and experience-based nature of wellness tourism, where the research objective was to understand satisfaction structures among actual wellness participants. Future studies employing probability-based sampling or cross-national designs could further enhance generalizability. Moreover, the demographic findings should be interpreted as descriptive rather than representative, and future studies employing random or stratified sampling designs are needed to establish a more generalizable wellness tourist profile.

Second, the cross-sectional design does not capture temporal changes in satisfaction or behavior, which are essential in understanding the evolution of wellness needs and preferences.

Third, the study focuses solely on tourist perceptions, without incorporating the perspectives of service providers or destination managers.

Future research should also aim to address these limitations through longitudinal studies and mixed-method designs that incorporate qualitative narratives and provider insights. Moreover, comparative studies across different cultural contexts or types of wellness services (e.g., spa-based vs. retreat-based) could provide a more granular understanding of satisfaction dynamics. Additional exploration of digital wellness tourism also constitutes a promising research field.

Lastly, future investigations should explore how wellness tourism can foster sustainable behavior change and contribute to broader public health outcomes. By framing wellness tourism not merely as a leisure activity but as a preventive health strategy, scholars and practitioners alike can better articulate its value proposition in both individual and societal terms.