Development and testing of a new instrument to measure patient satisfaction with health care in inflammatory bowel disease: the CACHE questionnaire.

BACKGROUND

Currently, there is no tool to evaluate satisfaction of patients with inflammatory bowel disease (IBD) with health care services. The objective of this study was to develop and test a new specific instrument to measure satisfaction with health care in patients with IBD.

METHODS

The questionnaire was developed using a literature review, a focus group with clinical experts, and administration of a provisional version to 20 patients with IBD. The final version of the questionnaire was validated in a longitudinal multicenter study in adult patients with IBD. The instrument's underlying dimension structure was analyzed using factor analysis, and its feasibility, reliability, and validity were assessed.

RESULTS

The final version of the CACHE questionnaire contains 31 items scored on a 5-point Likert-type scale. Scores were standardized to a range from 0 (minimum satisfaction) to 100 (maximum satisfaction). Factor analysis revealed 6 factors (staff care, clinician care, facilities, information, center accessibility, and support received), which explained 56% of variance. Overall, 91% of patients answered all items. Cronbach's alpha for the overall score was 0.93. There were no statistically significant correlations between the overall score and sociodemographic and clinical variables, but there was a statistically significant correlation between the time spent in the waiting room and the item measuring satisfaction with that aspect. There were no statistically significant changes in the overall score between the visits. The effect size was 0.016.

CONCLUSIONS

The CACHE questionnaire covers aspects relevant to the assessment of health care quality in patients with IBD and has proved to be feasible, reliable, and valid.