Department of Educational Psychology, University of North Texas, Denton, Texas, United States of America.
Department of Emergency Medicine, American University of Beirut, Beirut, Lebanon.
PLoS One. 2019 Aug 13;14(8):e0221087. doi: 10.1371/journal.pone.0221087. eCollection 2019.
The aim of the study was to investigate factors that best predict patient's satisfaction with their ED visit, as well as examine whether patients and their families perceived the factors related to satisfaction similarly.
This is a retrospective study where secondary data analysis was done on patient satisfaction data collected over three quarters for quality improvement purposes. Exploratory factor analysis (EFA) was conducted on the data from the first quarter to identify the factor structure, followed by confirmatory factor analysis (CFA) on the rest of the data to confirm the EFA factor structure. A structural equation model (SEM) was fitted where the factors predicted overall satisfaction with the ED visit. Finally, measurement invariance was conducted to examine if patients and families perceived the factors related to ED services alike.
Two factors were found to be predictive of satisfaction: clinical team and system processes. The SEM showed that system process was a statistically significant predictor of overall satisfaction, while clinical team predicted overall satisfaction to a smaller extent. Multi-group CFA showed that the factor structure fitted neither family nor patient groups adequately. The instrument did not exhibit partial invariance.
This study found that system process was the best predictor of overall satisfaction. Furthermore, this study showed that the same instrument might not reliably compare the perceptions of patients and families.
本研究旨在调查哪些因素能最好地预测患者对 ED 就诊的满意度,并检验患者及其家属对满意度相关因素的感知是否相似。
这是一项回顾性研究,对为质量改进目的而在三个季度内收集的患者满意度数据进行二次数据分析。对第一季度的数据进行探索性因子分析(EFA),以确定因子结构,然后对其余数据进行验证性因子分析(CFA),以确认 EFA 因子结构。拟合结构方程模型(SEM),用这些因素预测 ED 就诊的总体满意度。最后,进行测量不变性检验,以检验患者和家属对 ED 服务相关因素的感知是否相似。
发现两个因素对满意度具有预测作用:临床团队和系统流程。SEM 表明,系统流程是总体满意度的一个具有统计学意义的预测因素,而临床团队对总体满意度的预测作用较小。多组 CFA 显示,该因子结构不能很好地拟合家庭或患者群体。该工具没有表现出部分不变性。
本研究发现系统流程是总体满意度的最佳预测因素。此外,本研究表明,相同的工具可能无法可靠地比较患者和家属的感知。