Arch Hellen Med, 26(1), January-February 2009, 79-89
Development and psychometric assessment of a Greek-language inpatient satisfaction questionnaire
V.H. ALETRAS,1,2 F.N. BASIOURI,2 N. KONTODIMOPOULOS,2 D.M. IOANNIDOU,1 D.Α. NIAKAS2
OBJECTIVE Τhe primary research aim of this study was to develop a reliable and valid instrument for the measurement of inpatient satisfaction.
METHOD A questionnaire was created by means of literature review, on-site observation, cognitive interviews and pretesting. It contains 33 items expressed in a Likert format. Principal components analysis was applied to questionnaires from a sample of 150 inpatients hospitalized in April 2005 in a general public hospital in Veroia, Greece. Internal consistency reliability was examined with the use of Cronbach’s alpha coefficients. Test-retest and interrater reliability were measured via Pearson’s or Spearman’s and intraclass correlation coefficients, respectively. Multi-trait analysis was also conducted to assess convergent and divergent validity. Construct validation included examination of the association, using Kendall’s tau and Gamma statistics, of the time patients had to wait before being transferred into a ward and their beliefs about this interval. Moreover, Spearman correlations between summated scale scores and overall satisfaction, age and health status were computed. Finally, floor and ceiling effects were computed.
RESULTS The response rate was 64.65%. Principal components analysis revealed four factors, namely “physician and nursing care”, “organization of care”, “hospital environment” and “other quality factors”. Coefficients of internal consistency reliability ranged between 0.851 and 0.957 across scales. Test-retest reliability coefficients were between 0.814 and 0.970, whereas correlations of interrater reliability ranged from 0.811 to 0.978. Multitrait analysis indicated convergent validity. In addition, there was only one case in which the correlation of an item with its own scale was lower than the respective correlation with another scale, but the difference was not statistically significant. The questionnaire thus has very satisfactory divergent validity. The time patients had to wait before being transferred into the wards was positively associated with their level of agreement that the duration was longer than necessary. Summated scale scores had a statistically significant positive association with overall satisfaction and health status, but no association with age. Finally, there were no floor effects, while ceiling effects ranged from 6.66% to 43.33%. In the specific hospital in Veroia, the summated scales “physician and nursing care”, “organization of care”, “hospital environment” and “other quality factors” had mean (median) satisfaction scores of 4.36 (4.42), 4.59 (4.83), 4.26 (4.22) and 4.49 (4.50), respectively.
CONCLUSIONS The questionnaire developed was found to have very satisfactory reliability and validity properties. Further research is required for its further validation with the use of larger samples from different hospitals. Mean satisfaction from inpatient services in the Veroia General Hospital was high.
Key words: Hospital, Patient satisfaction, Questionnaire, Reliability, Validity.