Global Health Institute, College of Public Health, University of Georgia, Athens, Georgia, United States of America.
Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, Georgia, United States of America.
PLoS One. 2023 Feb 2;18(2):e0280732. doi: 10.1371/journal.pone.0280732. eCollection 2023.
Patient satisfaction is an important predictor of health outcomes among patients in HIV/AIDS treatment and care, yet it is rarely measured in routine clinic settings in most of Africa. The aims of our study were to evaluate the internal validity and reliability of the Consumer Assessment of Healthcare Providers and Systems instrument for measuring satisfaction, assess the general level of patient satisfaction, and identify the factors associated with the level of satisfaction among patients receiving antiretroviral therapy in Uganda.
We conducted a cross-sectional study of 475 HIV/AIDS-infected patients from July to August 2015 in Kampala, Uganda. Eligible participants were 18 years or older, consented to the study and receiving antiretroviral therapy and outpatient care at the selected public health clinic. This study used a modified version of the validated Consumer Assessment of Healthcare Providers and Systems (CAHPS) instrument to assess the level of satisfaction among HIV/AIDS patients receiving outpatient care. We collected data on socio-demographics, clinical variables and 18-items adapted from the CAHPS instrument rating satisfaction with aspects of health services. We conducted an exploratory factor analysis to assess the internal validity of the 18 items and multiple linear regression analysis of factors associated with patient satisfaction with care.
Majority of the respondents were females (76.8%), and the mean age was 37 years (SD = 10). The modified CAHPS instrument had high internal consistency (Cronbach's α = 0.94) for measuring satisfaction with HIV/AIDS care. Female sex (p = 0.016), perceived providers' technical and interpersonal skills (p = 0.022), emotional health (p = 0.032), and quality of reception services (p<0.001) were significantly associated with satisfaction in this urban HIV/AIDS public clinic.
The reliability of the CAHPS instrument was high for measuring satisfaction. Providers' technical and interpersonal skills, and the quality of reception services are key to achieving patient satisfaction. Health system interventions to address the gaps identified will enhance the quality of patient-centered HIV/AIDS care in the Ugandan setting.
患者满意度是评估 HIV/AIDS 治疗和护理患者健康结果的一个重要指标，但在非洲大多数国家的常规临床环境中，很少对其进行测量。我们研究的目的是评估用于测量满意度的医疗保健提供者和系统消费者评估工具的内部有效性和可靠性，评估患者的总体满意度水平，并确定乌干达接受抗逆转录病毒治疗的患者满意度水平相关因素。
我们于 2015 年 7 月至 8 月在乌干达坎帕拉对 475 名 HIV/AIDS 感染者进行了一项横断面研究。合格的参与者年龄在 18 岁或以上，同意参与研究，并在选定的公共诊所接受抗逆转录病毒治疗和门诊护理。本研究使用经过验证的医疗保健提供者和系统消费者评估（CAHPS）工具的改良版本来评估接受门诊护理的 HIV/AIDS 患者的满意度水平。我们收集了社会人口统计学、临床变量和 18 项来自 CAHPS 工具的指标数据，用于评估对卫生服务各方面的满意度。我们进行了探索性因子分析，以评估 18 项指标的内部有效性，并对与患者对护理满意度相关的因素进行了多元线性回归分析。
大多数受访者为女性（76.8%），平均年龄为 37 岁（标准差=10）。改良后的 CAHPS 工具对测量 HIV/AIDS 护理满意度具有较高的内部一致性（Cronbach's α=0.94）。女性（p=0.016）、感知提供者的技术和人际交往技能（p=0.022）、心理健康（p=0.032）和接待服务质量（p<0.001）与该城市 HIV/AIDS 公共诊所的满意度显著相关。
CAHPS 工具用于测量满意度的可靠性较高。提供者的技术和人际交往技能以及接待服务质量是实现患者满意度的关键。为解决确定的差距而采取的卫生系统干预措施将增强乌干达以患者为中心的 HIV/AIDS 护理质量。
