使用咨询满意度调查问卷来评估患者对全科医生和社区护士的满意度：信度、可重复性和区分效度。
Use of the consultation satisfaction questionnaire to examine patients' satisfaction with general practitioners and community nurses: reliability, replicability and discriminant validity.
作者信息
Poulton B C
机构信息
Daphne Heald Research Unit, Royal College of Nursing of the United Kingdom, London.
出版信息
Br J Gen Pract. 1996 Jan;46(402):26-31.
BACKGROUND
Primary health care services are the most frequently used in the health care system. Consumer feedback on these services is important. Research in this area relates mainly to doctor-patient relationships which fails to reflect the multidisciplinary nature of primary health care.
AIM
A pilot study aimed to examine the feasibility of using a patient satisfaction questionnaire designed for use with general practitioner consultations as an instrument for measuring patient satisfaction with community nurses.
METHOD
The questionnaire measuring patient satisfaction with general practitioner consultations was adapted for measuring satisfaction with contacts with a nurse practitioner, district nurses, practice nurses and health visitors. A total of 1575 patients in three practices consulting general practitioners or community nurses were invited to complete a questionnaire. Data were subjected to principal components analysis and the dimensions identified were tested for internal reliability and replicability. To establish discriminant validity, patients' mean satisfaction scores for consultations with general practitioners, the nurse practitioner, health visitors and nurses (district and practice nurses) were compared.
RESULTS
Questionnaires were returned relating to 400 general practitioner, 54 nurse practitioner, 191 district/practice nurse and 83 health visitor consultations (overall response rate 46%). Principal components analysis demonstrated a factor structure similar to that found in an earlier study of the consultation satisfaction questionnaire. Three dimensions of patient satisfaction were identified: professional care, depth of relationship and perceived time spent with the health professional. The dimensions were found to have acceptable levels of reliability. Factor structures obtained from data relating to general practitioner and community nurse consultations were found to correlate significantly. Comparison between health professionals showed that patients rated satisfaction with professional care significantly more highly for nurses than for general practitioners and health visitors. Patients' rating of satisfaction with the depth of relationships with health visitors was significantly lower than their ratings of this relationship with the other groups of health professionals. There were so significant differences between health professional groups regarding patients' ratings of satisfaction with the perceived amount of time spent with health professionals.
CONCLUSION
The pilot study showed that it is possible to use the consultation satisfaction questionnaire for both general practitioners and community nurses. Comparison between health professional groups should be undertaken with caution as data were available for only a small number of consultations with some of the groups of health professionals studied.
背景
初级卫生保健服务是医疗保健系统中使用最为频繁的服务。消费者对这些服务的反馈很重要。该领域的研究主要涉及医患关系，未能反映初级卫生保健的多学科性质。
目的
一项试点研究旨在检验使用专为全科医生会诊设计的患者满意度调查问卷作为衡量患者对社区护士满意度的工具的可行性。
方法
将测量患者对全科医生会诊满意度的问卷进行改编，以测量对与执业护士、社区护士、诊所护士和健康访视员接触的满意度。邀请了三家诊所中咨询全科医生或社区护士的1575名患者填写问卷。对数据进行主成分分析，并对所确定的维度进行内部信度和可重复性测试。为了建立区分效度，比较了患者对与全科医生、执业护士、健康访视员和护士（社区护士和诊所护士）会诊的平均满意度得分。
结果
共收回了与400次全科医生会诊、54次执业护士会诊、191次社区/诊所护士会诊和83次健康访视员会诊相关的问卷（总体回复率46%）。主成分分析显示出与早期会诊满意度调查问卷研究中发现的因素结构相似。确定了患者满意度的三个维度：专业护理、关系深度以及与卫生专业人员相处的感知时间。发现这些维度具有可接受的信度水平。从与全科医生和社区护士会诊相关的数据中获得的因素结构被发现具有显著相关性。卫生专业人员之间的比较表明，患者对护士专业护理的满意度评分显著高于对全科医生和健康访视员的评分。患者对与健康访视员关系深度的满意度评分显著低于对与其他卫生专业人员群体关系的评分。在患者对与卫生专业人员相处感知时间的满意度评分方面，卫生专业人员群体之间没有显著差异。
结论
试点研究表明，会诊满意度调查问卷可同时用于全科医生和社区护士。由于仅获得了与部分所研究的卫生专业人员群体的少量会诊数据，因此在进行卫生专业人员群体之间的比较时应谨慎。
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