Abstract
BackgroundPatient experiences are an important aspect of health care quality, but there is a lack of validated instruments for their measurement in the substance dependence literature. A new questionnaire to measure inpatients’ experiences of interdisciplinary treatment for substance dependence has been developed in Norway. The aim of this study was to psychometrically test the new questionnaire, using data from a national survey in 2013.MethodsThe questionnaire was developed based on a literature review, qualitative interviews with patients, expert group discussions and pretesting. Data were collected in a national survey covering all residential facilities with inpatients in treatment for substance dependence in 2013. Data quality and psychometric properties were assessed, including ceiling effects, item missing, exploratory factor analysis, and tests of internal consistency reliability, test-retest reliability and construct validity.ResultsThe sample included 978 inpatients present at 98 residential institutions. After correcting for excluded patients (n = 175), the response rate was 91.4%. 28 out of 33 items had less than 20.5% of missing data or replies in the “not applicable” category. All but one item met the ceiling effect criterion of less than 50.0% of the responses in the most favorable category. Exploratory factor analysis resulted in three scales: “treatment and personnel”, “milieu” and “outcome”. All scales showed satisfactory internal consistency reliability (Cronbach’s alpha ranged from 0.75-0.91) and test-retest reliability (ICC ranged from 0.82-0.85). 17 of 18 significant associations between single variables and the scales supported construct validity of the PEQ-ITSD.ConclusionThe content validity of the PEQ-ITSD was secured by a literature review, consultations with an expert group and qualitative interviews with patients. The PEQ-ITSD was used in a national survey in Norway in 2013 and psychometric testing showed that the instrument had satisfactory internal consistency reliability and construct validity.
Highlights
Patient experiences are an important aspect of health care quality, but there is a lack of validated instruments for their measurement in the substance dependence literature
The aim of this study was to test the construct validity and internal consistency reliability of a new questionnaire following the national survey in Norway in 2013
The resulting questionnaire was cognitively tested with patients (n = 15), and lastly, a pilot survey was conducted with 14 institutions (n = 329)
Summary
Patient experiences are an important aspect of health care quality, but there is a lack of validated instruments for their measurement in the substance dependence literature. One issue with satisfaction surveys is that they often report high satisfaction [3,4,5,6], challenging the usefulness of satisfaction surveys in quality improvement work, and calling for a more nuanced and multi-faceted approach [7]. Asking patients about their experiences of the health care delivery system has been identified as a useful method for establishing trends over time and comparisons among providers [2]
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