Center for Functional GI and Motility Disorders, University of North Carolina, Chapel Hill, North Carolina 27599-7080, USA.
Clin Gastroenterol Hepatol. 2011 Dec;9(12):1065-71.e1-2. doi: 10.1016/j.cgh.2011.08.009. Epub 2011 Aug 18.
BACKGROUND & AIMS: Satisfaction with care is an important measure of quality, from the patients' perspective, and could also affect outcomes. However, there is no standard measure of patient satisfaction for irritable bowel syndrome (IBS) care; a multi-item, condition-specific instrument is needed.
Using standard qualitative methods, we conducted focus groups to identify items that patients associated with satisfaction in their care for IBS. These and additional items identified by experts were placed into a preliminary questionnaire, which was refined through pilot testing and cognitive debriefing by additional patients, as well as standard statistical methods. The resulting instrument and several external validation measures were administered to 300 adult US patients with IBS. Factor analysis was performed to identify clinically relevant subscales and then psychometric properties were assessed.
We developed an IBS satisfaction with care scale (IBS-SAT) that has 38 items from 5 clinically relevant subscales (connection with provider, education, benefits of visit, office attributes, and access to care). This IBS-SAT had a high level of internal consistency (Crohnbach's α = .96). Convergent validity was established by correlations between the IBS-SAT and a single, global satisfaction with care question (r = 0.68; P < .001), and a generic, multi-item satisfaction scale (physician satisfaction questionnaire-18) (r = 0.75, P < .001). Discriminant validity (among known groups) was established across groups that were stratified based on IBS-quality of life (r = 0.34; P < .0001), IBS severity (functional bowel disorders severity index) (r = -0.21; P < .001), and number of unmet expectations (r = -0.38; P < .0001).
The IBS-SAT is a validated measure of patient satisfaction with IBS care. As a new, condition-specific instrument, it is likely to be a useful tool for quality measurement, health services research, and clinical trials.
从患者的角度来看，对医疗护理的满意度是衡量医疗质量的一个重要指标，它也可能影响治疗效果。然而，目前并没有针对肠易激综合征（IBS）护理的患者满意度标准衡量工具；我们需要一种多项目、针对特定疾病的仪器。
我们采用标准的定性方法，通过焦点小组讨论确定了患者对 IBS 护理满意度的相关项目。这些项目和专家提出的其他项目被纳入初步问卷中，经过初步测试、认知审查（由其他患者完成）以及标准的统计方法进行了完善。该仪器以及其他几个外部验证措施被用于 300 名美国成年 IBS 患者。我们进行了因子分析以确定有临床意义的亚量表，然后评估了心理测量特性。
我们开发了一种肠易激综合征护理满意度量表（IBS-SAT），它包含 5 个有临床意义的亚量表（与提供者的联系、教育、就诊获益、办公属性和获得护理的机会）的 38 个项目。该 IBS-SAT 具有较高的内部一致性（Cronbach's α =.96）。通过与单一的、总体护理满意度问题（r = 0.68；P <.001）和通用的、多项目满意度量表（医生满意度问卷-18）（r = 0.75，P <.001）的相关性，我们确立了其聚合效度。通过根据 IBS 生活质量（r = 0.34；P <.0001）、IBS 严重程度（功能性肠病严重指数）（r = -0.21；P <.001）和未满足的期望数量（r = -0.38；P <.0001）分层的已知群体之间的差异，确立了判别效度。
IBS-SAT 是一种经过验证的患者对 IBS 护理满意度的衡量工具。作为一种新的、针对特定疾病的仪器，它很可能成为质量衡量、卫生服务研究和临床试验的有用工具。
