Development and testing of a measure of patient satisfaction with nursing care

Abstract

The purpose of this research was to test an empirically derived measure of patient satisfaction with nursing care. Existing measures of this important phenomenon lack adequate validity and a strong theoretical base. A grounded theory study was completed with patients discharged from medical surgical units of a tertiary care facility. The results of that study provided the theoretical basis for the development of a measure of patient satisfaction with nursing care that was grounded in the experience of experts—the patients who have received nursing care.

The initial 37-item, 7-factor measure was tested in a sample of discharged medical surgical patients. Reliability was assessed through internal consistency. Construct validity was assessed through confirmatory factor analysis.

Acceptable reliability was obtained for the 7-factor model. In confirmatory factor analysis, the model did not fit the data at an acceptable level. Subsequently, model generating strategies were undertaken to improve the fit of individual constructs. The model demonstrating the best fit to the data consisted of 15 items and 4 factors. These factors include Seeing the Individual Patient, Explaining, Responding, and Watching Over. This model was validated using data from a holdout sample of patient responses and adequate fit of the model to the data was obtained.

Validity was assessed by correlating the subscales of the 15-item, 4-factor model to the two widely used measures of patient satisfaction with nursing care. All results were consistent with predictions. As additional evidence of validity, the relationships between the subscales of the 4-factor measure and measures of general satisfaction with the care experience and the extent to which patients were following discharge instructions were examined. All relationships were consistent with predictions.

Based on the findings of this study, the measure is judged as a reliable and valid measure of patient satisfaction with nursing care in the hospital setting. Implications for nursing practice, education, research, and administration, as well as methodological issues for instrument development are presented. Suggestions for future research using the measure are also presented.