Validating Patient Perspectives: A Study on the Reliability of Satisfaction Survey Tools

Overview

Journal Patient Prefer Adherence

Date 2025 Mar 6

PMID 40046562

Authors

Lorena Charrier

Andrea Ricotti

Fabiana Marnetto

Rosanna Irene Comoretto

Paola Berchialla

Elena Cristina Carratello

Mariacristina Favero Fra

Graziella Costamagna

Paola Dalmasso

Maria Carmen Azzolina

Affiliations

Soon will be listed here.

Abstract

Purpose: Patient perceptions of care quality can guide targeted improvements. Valid and reliable measures are essential for meaningful patient satisfaction assessment, but no validated questionnaires were found among those used in most Italian hospitals. This study aimed to assess the internal reliability and construct validity of two patient satisfaction questionnaires (one for outpatient care and one for inpatient care) developed at Ordine Mauriziano Hospital in Torino, Italy.

Patients And Methods: The questionnaires underwent face and content validation based on literature, brainstorming, and expert input. After Ethics Committee approval, patients admitted to or accessing the Ordine Mauriziano Hospital for outpatient visits completed the inpatient and outpatient care questionnaires, respectively. Responses were analyzed for internal reliability (Cronbach's ɑ) and construct validity using confirmatory factor analysis (CFA).

Results: Between February and May 2024, 371 outpatient and 374 inpatient questionnaires were fully completed (78%). Both questionnaires' specific subscales showed high internal reliability (Cronbach's ɑ ≥0.80) and a significant positive correlation with overall satisfaction, confirming construct validity. CFA fit indices met recommended thresholds: CFI>0.9, RMSEA, and SRMR<0.08.

Conclusion: The results suggest that both questionnaires are valid and reliable for assessing patient satisfaction. They offer valuable insights for healthcare personnel and managers to improve care by focusing efforts and investments on areas needing enhancement and strengthening successful dimensions. Moreover, the widespread use of these tools at the regional level will provide decision-makers with more robust and comparable data over time and across care facilities.

References

Harris P, Taylor R, Thielke R, Payne J, Gonzalez N, Conde J . Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2008; 42(2):377-81. PMC: 2700030. DOI: 10.1016/j.jbi.2008.08.010. View

Dunsch F, Evans D, Macis M, Wang Q . Bias in patient satisfaction surveys: a threat to measuring healthcare quality. BMJ Glob Health. 2018; 3(2):e000694. PMC: 5898299. DOI: 10.1136/bmjgh-2017-000694. View

Batbaatar E, Dorjdagva J, Luvsannyam A, Savino M, Amenta P . Determinants of patient satisfaction: a systematic review. Perspect Public Health. 2016; 137(2):89-101. DOI: 10.1177/1757913916634136. View

Tsang S, Royse C, Terkawi A . Guidelines for developing, translating, and validating a questionnaire in perioperative and pain medicine. Saudi J Anaesth. 2017; 11(Suppl 1):S80-S89. PMC: 5463570. DOI: 10.4103/sja.SJA_203_17. View

Gonzalez N, Quintana J, Bilbao A, Escobar A, Aizpuru F, Thompson A . Development and validation of an in-patient satisfaction questionnaire. Int J Qual Health Care. 2005; 17(6):465-72. DOI: 10.1093/intqhc/mzi067. View

Abramowitz S, Cote A, Berry E . Analyzing patient satisfaction: a multianalytic approach. QRB Qual Rev Bull. 1987; 13(4):122-30. DOI: 10.1016/s0097-5990(16)30118-x. View

Everitt B . Multivariate analysis: the need for data, and other problems. Br J Psychiatry. 1975; 126:237-40. DOI: 10.1192/bjp.126.3.237. View

White M . Sample size in quantitative instrument validation studies: A systematic review of articles published in Scopus, 2021. Heliyon. 2022; 8(12):e12223. PMC: 9768294. DOI: 10.1016/j.heliyon.2022.e12223. View

Kleefstra S, Kool R, Veldkamp C, Winters-van der Meer A, Mens M, Blijham G . A core questionnaire for the assessment of patient satisfaction in academic hospitals in The Netherlands: development and first results in a nationwide study. Qual Saf Health Care. 2010; 19(5):e24. DOI: 10.1136/qshc.2008.030825. View

10.

Konerding U, Bowen T, Elkhuizen S, Faubel R, Forte P, Karampli E . Development of a universal short patient satisfaction questionnaire on the basis of SERVQUAL: Psychometric analyses with data of diabetes and stroke patients from six different European countries. PLoS One. 2019; 14(10):e0197924. PMC: 6797181. DOI: 10.1371/journal.pone.0197924. View

11.

Harris L, Swindle R, Mungai S, Weinberger M, Tierney W . Measuring patient satisfaction for quality improvement. Med Care. 1999; 37(12):1207-13. DOI: 10.1097/00005650-199912000-00004. View

12.

Harris P, Taylor R, Minor B, Elliott V, Fernandez M, ONeal L . The REDCap consortium: Building an international community of software platform partners. J Biomed Inform. 2019; 95:103208. PMC: 7254481. DOI: 10.1016/j.jbi.2019.103208. View

13.

Eubank B, Lafave M, Mohtadi N, Sheps D, Wiley J . Validation of a tool to assess patient satisfaction, waiting times, healthcare utilization, and cost. Prim Health Care Res Dev. 2020; 20:e47. PMC: 6598225. DOI: 10.1017/S1463423619000094. View

14.

Abbasi-Moghaddam M, Zarei E, Bagherzadeh R, Dargahi H, Farrokhi P . Evaluation of service quality from patients' viewpoint. BMC Health Serv Res. 2019; 19(1):170. PMC: 6420766. DOI: 10.1186/s12913-019-3998-0. View

15.

Tomietto M, Papastavrou E, Suhonen R, Leino-Kilpi H, Palese A . [Italian validation of the Patient Satisfaction Scale]. Ann Ig. 2011; 23(3):195-202. View

16.

Wei J, Wang X, Yang H, Yang T . Development of an In-Patient Satisfaction Questionnaire for the Chinese Population. PLoS One. 2015; 10(12):e0144785. PMC: 4684244. DOI: 10.1371/journal.pone.0144785. View

17.

Piredda M, Vellone E, Piras G, Fida R, Latour J, Matarese M . Psychometric evaluation of the Newcastle Satisfaction with Nursing Scales. J Nurs Care Qual. 2014; 30(1):84-92. DOI: 10.1097/NCQ.0000000000000078. View

18.

Akin S, Erdogan S . The Turkish version of the Newcastle Satisfaction with Nursing Care Scale used on medical and surgical patients. J Clin Nurs. 2007; 16(4):646-53. DOI: 10.1111/j.1365-2702.2006.01583.x. View

19.

Grogan S, Conner M, Norman P, Willits D, Porter I . Validation of a questionnaire measuring patient satisfaction with general practitioner services. Qual Health Care. 2000; 9(4):210-5. PMC: 1743536. DOI: 10.1136/qhc.9.4.210. View

20.

Sitzia J, Wood N . Patient satisfaction: a review of issues and concepts. Soc Sci Med. 1998; 45(12):1829-43. DOI: 10.1016/s0277-9536(97)00128-7. View