Looking Through the Patients' Eyes: Measuring Patient Satisfaction in a Public Hospital

The use and quality of reporting of Rasch analysis in nursing research: A methodological scoping review

BACKGROUND

Rasch analysis is widely used in the life sciences. Rasch analysis is a mathematical and probabilistic model based on the assumption that the probability of passing a single item is governed by a person's ability and the difficulty of the item. However, its use in nursing science remains unclear.

AIM

To (i) describe the use of Rasch analysis in nursing research and (ii) determine the quality of reporting in nursing studies using Rasch models.

METHODS

A methodological scoping review of literature was conducted. The systematic electronic literature search was initially conducted on 1 February 2020 and updated on 16 April 2021 from PubMed/Medline and CINAHL databases. The search was limited to covering the timeframe from the earliest literature available until 31 December 2020. The search terms used were Rasch, IRT, item response theory, and nursing. The search was limited to the English language and title/abstract level. The analysis included quantification and content analysis.

RESULTS

In total, 388 hits were identified. Following a two-phase retrieval process, 88 articles were included in the final analysis. Rasch analysis was used to test the psychometric properties of the newly developed instrument, and validate or test a short version of the existing instrument. The reporting of Rasch analysis demonstrated large variability in quality. Rating scale functioning, internal scale validity using goodness-of-fit statistics, and unidimensionality were the most frequently reported outcomes.

CONCLUSION

The use of Rasch analysis in nursing science was found to be unsystematic. Rasch analysis could provide new possibilities for investigating measurement properties. However, robust, comprehensive, and precise reporting of the methodological choices and results of Rasch analysis is needed. Furthermore, the use of Rasch analysis in nursing science is encouraged.

WHAT IS ALREADY KNOWN

WHAT THIS PAPER ADDS.

Validation of the Italian version of the spirituality and spiritual care rating scale (SSCRS‐ita)

PURPOSE

To translate and validate the Italian version of the Spirituality and Spiritual Care Rating Scale (SSCRS-ita).

METHODS

A single-center cross-sectional study was performed from October 15 to November 15, 2019 in a public hospital in Milan, Italy. The scale was drafted using the back-translation method. Prior to administration, the Italian version of the scale was assessed for content validity and retest stability by calculating the content validity index. Internal consistency was investigated by calculating Cronbach's alpha coefficient, test-retest stability by Spearman's rho coefficient.

FINDINGS

A total n = 337 nurses participated in the survey by correctly completing the scale. The Kaiser-Meyer-Olkin test (0.81) and Bartlett's test of sphericity (p < 0.001) confirmed the adequacy of the sample to conduct exploratory factor analysis (EFA). The factorial model of EFA without rotation and then with nonorthogonal Promax rotation confirmed the presence of the four constructs identified by the original author.

CONCLUSIONS

SSCRS-ita showed promising psychometric properties in terms of validity and reliability. The results of this study, together with the lack of in-depth studies in the Italian health and educational panorama, suggest the need to develop an educational pathway which, starting from the curricula of basic training and continuing with the updating of nursing staff, is dedicated to the detection of the spiritual needs of the patient.

IMPLICATIONS FOR NURSING PRACTICE

The SSCRS-ita is the first validated Italian tool concerning the consideration of the needs of spirituality and spiritual care in healthcare contexts; the possibility to use this tool is the first step towards a better integration of the mentioned dimensions of care in a nursing care qualitative perspective in Italy.

Psychometric evaluation of patient-reported experience measures: is it valid?

Multiple published studies and reviews have advocated the application of psychometric methods to the validation of patient experience measurement. Some such methods depend on measurement assumptions that may not be appropriate for patient experience. Rather than being the default approach for the validation of patient experience measurement, we argue that psychometric methods should be reviewed critically to determine their fit to the measurement application, and alternative approaches explored, so that the most appropriate validation methods can be identified.

A third-party investigation of inpatient satisfaction with a tertiary hospital in People's Republic of China

BACKGROUND

Conflicts between doctors and patients occur in People's Republic of China each year. Serious negative relationships between doctors and patients are a significant social problem. This study aims to evaluate the satisfaction of inpatients in a tertiary hospital through a third party and analyze the relationship between sociodemographic characteristics and overall satisfaction.

PATIENTS AND METHODS

A cross-sectional investigation was conducted to obtain the demographic information and results for 20 items in an inpatient satisfaction questionnaire. A total of 872 inpatients were studied. Descriptive analysis was conducted using SPSS version 22.0 software. Independent sample t-tests and one-way ANOVA were used to compare the mean differences between groups. Multiple linear regression analysis was conducted to study the relationship between different demographic characteristics and overall satisfaction. P-values of <0.05 were considered significant. Matrix analysis was used to predict which of the 20 items had a higher priority for patient satisfaction.

RESULTS

Among the respondents, valid questionnaires were completed by 872 patients, with a response rate of 94.47% (872/923). The hospital inpatient satisfaction score was 84.92±10.34. Among the sociodemographic characteristics, education status, occupation, annual income, residence and frequency of visits were related to inpatient satisfaction and were statistically significant (P<0.05). However, sex, age and marital status were not significantly different in terms of the inpatient satisfaction score (P>0.05). Multiple linear regression analysis results showed that residence, age, occupation and education status were the factors affecting inpatient satisfaction. In further analyses, diet management, medical expenses, complaint management and hospital environment were in urgent need of improvement.

CONCLUSION

The overall level of inpatient satisfaction with this hospital seems to be acceptable, although areas for improvement remain.