Boter Han, De Haan Rob J, Rinkel Gabriël J E
University Department of Neurology, University Medical Centre Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands.
J Neurol. 2003 May;250(5):534-41. doi: 10.1007/s00415-003-1031-2.
There is a lack of sound instruments for measuring patient satisfaction with stroke care. One self-report instrument comprising two subscales, satisfaction with inpatient care and satisfaction with care after discharge, has been validated, but only in the United Kingdom. In later studies, items have been added without further validation. Therefore, we tested this extended questionnaire (Satisfaction with Stroke Care questionnaire; SASC-19) for feasibility, reliability (homogeneity and test-retest agreement), and construct validity (convergent and divergent validity and factor analysis) in the Netherlands in 166 prospectively collected stroke patients living at home 6 months after discharge. To determine the test-retest reliability, 51 patients completed the SASC-19 again two weeks after they first completed it. The response rate was 90 %; the mean time needed to complete the SASC-19 was less than 10 minutes. Six items were omitted by more than 10 % of the patients. Both subscales showed good homogeneity and almost perfect test-retest reliability (Cronbach's alpha's > 0.80; Intraclass Correlation Coefficients > 0.80). The correlations with the General Satisfaction questionnaire (convergent validity) ranged between 0.33 and 0.55; those with the Barthel Index, the Hospital Anxiety and Depression Scale (HADS), and the Short Form 36 (SF-36) health survey questionnaire (divergent validity) ranged between 0.12 and 0.47. Factor analysis showed a total explained variance of 49 %, which supports the subscale structure. We conclude that the SASC-19 is a reliable and valid instrument for measuring patient satisfaction with stroke care and it is easy to complete. The feasibility in terms of missing values is moderate.
目前缺乏完善的工具来衡量患者对中风护理的满意度。有一种自我报告工具，包含两个子量表，即对住院护理的满意度和对出院后护理的满意度，已经经过验证，但仅在英国。在后续研究中，又增加了一些项目，但未进行进一步验证。因此，我们在荷兰对166名出院6个月后居家的前瞻性收集的中风患者，测试了这份扩展问卷（中风护理满意度问卷；SASC - 19）的可行性、信度（同质性和重测一致性）和结构效度（收敛效度、区分效度和因子分析）。为了确定重测信度，51名患者在首次完成SASC - 19两周后再次完成该问卷。应答率为90%；完成SASC - 19所需的平均时间不到10分钟。超过10%的患者遗漏了6个项目。两个子量表均显示出良好的同质性和几乎完美的重测信度（Cronbach's α系数> 0.80；组内相关系数> 0.80）。与一般满意度问卷的相关性（收敛效度）在0.33至0.55之间；与Barthel指数、医院焦虑抑郁量表（HADS）和简明健康调查问卷（SF - 36）的相关性（区分效度）在0.12至0.47之间。因子分析显示总解释方差为49%，这支持了子量表结构。我们得出结论，SASC - 19是一种可靠且有效的工具，用于测量患者对中风护理的满意度，并且易于完成。在缺失值方面的可行性适中。
