The Italian version of the Physical Therapy Patient Satisfaction Questionnaire - [PTPSQ-I(15)]: psychometric properties in a sample of inpatients

Community Pharmacist's Role in Detecting Low Back Pain, and Patient Attitudes-A Cross-Sectional Observational Study in Italian Community Pharmacies

BACKGROUND

Low back pain (LBP) is one of the most frequent diseases for which patients seek advice in a community pharmacy. The study aimed to evaluate the feasibility of the administration by community pharmacists of questionnaires to assess the LBP intensity and disability degree in patients entering community pharmacies and the attitudes they have toward pain management by pharmacological and non-pharmacological strategies.

METHODS

An explorative, cross-sectional, observational, and quantitative study was performed. Twelve Italian community pharmacists were asked to submit a questionnaire on LBP to patients visiting their pharmacies. The questionnaire included a pain intensity scale, and two validated tools: the Roland and Morris Disability Questionnaire (RMDQ) and the Start Back Screening Tool (SBST) to determine the degree and risk of patient disability, respectively.

RESULTS

872 patients filled out the questionnaires in 6 months. No statistical differences between genders (p > 0.30) were recorded for pain intensity (Female: median score 6, IQR 4-7; Male: median scores 5, IQR 4-7; p > 0.30) and disability associated with LBP (RMDQ high-disability level: Females, 14.7%, Males, 15.0%; p > 0.90). Most of the patients (69%) reported a low degree of disability, but the risk of disability was medium and high in 36% and 18% of them, respectively (p < 0.05). About 14% of patients declare to never seek for physician's advice despite their medium-high degree of disability.

CONCLUSION

The study demonstrated the feasibility of validated tools for assessing the degree and risk of disability in LBP patients administrable in community pharmacies. Moreover, the community pharmacy resulted in an important care portal for patients suffering from moderate LBP and for intercepting patients who suffered from severe LBP but had never reported their problem to their physician.

Construction, Factor Structure, and Internal Consistency Reliability of the Hospital Physical Therapy Perceived Satisfaction Questionnaire (H-PTPS)

Patient satisfaction is a crucial aspect in the evaluation of the quality of health care provided by health services and units, especially in patients that require physical rehabilitation. This study aims to design and analyze the factor structure and internal consistency reliability of the Hospital Physical Therapy Perceived Satisfaction Questionnaire (H-PTPS) measuring the level of physical therapy patient satisfaction in hospital rehabilitation services. This study has a multicenter cross-sectional survey design. This study used the structural validity and internal consistency domains from COSMIN (consensus-based standards for the selection of health status measurement instruments) guideline. The H-PTPS questionnaire consists of 20 closed questions. A sample of 384 adult patients from physical therapy units from three Spanish public hospitals completed this questionnaire. A factor structure and internal consistency reliability analysis were performed. The factor analysis including the 20 items of the H-PTPS showed an adequacy index of 0.922 according to the Kaiser–Meyer–Olkin measure and the Barlett test allowed us to reject the null hypothesis (p < 0.001). In the rotated component matrix, four specific factors were obtained, explaining 66.75% of the accumulated variance. All factors present satisfactory internal reliability, achieving Cronbach’s alpha indices and Omega coefficients higher than 0.74. The H-PTPS questionnaire has shown a four-factor solution with satisfactory reliability evaluating the satisfaction of Spanish patients treated in physical therapy units in the hospital rehabilitation services.

The Turkish version of the MedRisk instrument for measuring patient satisfaction: measurement properties in physical therapy care among inpatients

Purpose: Our aim was to cross culturally adapt the MedRisk instrument for measuring patient satisfaction with physical therapy care for Turkish-speaking inpatients, provide information about its measurement properties, and determine the socio-demographic factors influencing satisfaction of Turkish patients.Method: This was a cross-sectional, measurement-focused study. The MedRisk instrument for measuring patient satisfaction was translated and adapted into Turkish. Two hundred four inpatients with different health conditions from different units of a large university hospital were assessed using the Turkish version of the MedRisk instrument for measuring patient satisfaction. Forty-two patients were reassessed after 72 h. Construct validity, internal consistency, convergent validity, criterion-referenced validity, floor and ceiling effects, and test-retest reliability were evaluated.Results: Factor analysis showed a two-factor structure. Cronbach's alpha values for the internal consistency ranged between 0.49 and 0.81. Corrected item-total correlations ranged between 0.29 and 0.72. Intraclass correlation coefficients ranged between 0.67 and 0.97, standard errors of measurement ranged between 0.34 and 2.61 points, and substantially good agreement was achieved. Eleven of twelve items were positively correlated with the global measures. No floor or ceiling effects were detected. The satisfaction level of inpatients was high.Conclusions: Our results suggested that the Turkish version of the MedRisk instrument for measuring patient satisfaction is a quite reliable and valid measurement to evaluate patient satisfaction with physical therapy care in Turkish-speaking inpatients. We determined that Turkish inpatients are highly satisfied with their physical therapy care, and they consider the patient-physical therapist relationship important.Implications for rehabilitationThe Turkish version of the MedRisk instrument for measuring patient satisfaction is a reliable and valid translation of the original MedRisk instrument for measuring patient satisfaction.However, it should be noted that three items from the original version were excluded.Clinicians and relevant researchers can use this instrument to evaluate satisfaction with physical therapy care among Turkish-speaking inpatients.

Patients' perceptions of healthcare professionalism-a Romanian experience

Background

The main objective of this cross sectional study was to assess the psychometric properties of a new research instrument. The secondary aim was to analyze patients’ levels of dissatisfaction with the professionalism of medical staff.

Methods

A social survey questionnaire was created and administered online. The instrument consisted of two scales: the 30-item patient dissatisfaction scale and the 10 items institutional scale. In this article, we assessed only the patient dissatisfaction scale. The research population includes 1838 subjects. The statistical procedures used were descriptive statistics, Pearson’s correlation, and factorial analyses with the SPSS.19 software. The internal consistency of the instrument was determined using the Cronbach’s alpha coefficient. We used a principal component analysis to investigate the factorial validity of the scale.

Results

The patients’ scale of dissatisfaction obtained an alpha Cronbach score of 0.81. Three latent factors corresponding to three dimensions of dissatisfaction emerged from the data: medical staff’s ability to communicate, medical staff’s hygiene, as well as sanitary and privacy conditions within the hospital. The first factor explained 43.47% of the variance in patient dissatisfaction, the second factor explained 10.24%, and the third factor explained 7.59%; overall, the three factors explained 61.30% of the total variance.

Conclusion

The Romanian healthcare system has an organization and management structure which has shown few changes since the communist period. Our study indicates that although more than 25 years have passed since the political regime changed in Romania and the introduction of a different system of social care, there have been no corresponding changes in the medical staff’s mentality or in the way that patients are approached. The present assessment of patient dissatisfaction is not a strictly theoretical exercise; it also represents a valuable instrument for healthcare system management.

Electronic supplementary material

The online version of this article (doi:10.1186/s12913-017-2412-z) contains supplementary material, which is available to authorized users.

Which kind of psychometrics is adequate for patient satisfaction questionnaires?

The construction and psychometric analysis of patient satisfaction questionnaires are discussed. The discussion is based upon the classification of multi-item questionnaires into scales or indices. Scales consist of items that describe the effects of the latent psychological variable to be measured, and indices consist of items that describe the causes of this variable. Whether patient satisfaction questionnaires should be constructed and analyzed as scales or as indices depends upon the purpose for which these questionnaires are required. If the final aim is improving care with regard to patients' preferences, then these questionnaires should be constructed and analyzed as indices. This implies two requirements: 1) items for patient satisfaction questionnaires should be selected in such a way that the universe of possible causes of patient satisfaction is covered optimally and 2) Cronbach's alpha, principal component analysis, exploratory factor analysis, confirmatory factor analysis, and analyses with models from item response theory, such as the Rasch Model, should not be applied for psychometric analyses. Instead, multivariate regression analyses with a direct rating of patient satisfaction as the dependent variable and the individual questionnaire items as independent variables should be performed. The coefficients produced by such an analysis can be applied for selecting the best items and for weighting the selected items when a sum score is determined. The lower boundaries of the validity of the unweighted and the weighted sum scores can be estimated by their correlations with the direct satisfaction rating. While the first requirement is fulfilled in the majority of the previous patient satisfaction questionnaires, the second one deviates from previous practice. Hence, if patient satisfaction is actually measured with the final aim of improving care with regard to patients' preferences, then future practice should be changed so that the second requirement is also fulfilled.