Development of a questionnaire to measure patients'' satisfaction with general practitioners'' services.

BACKGROUND. It is now a requirement that patients' satisfaction with the services obtained from their general practitioner should be surveyed. AIM. The aim of the study was to produce a reliable and valid multidimensional patient satisfaction questionnaire that could be used in general practice. METHOD. Items were originally derived from patients' responses to open-ended questions. The resulting 148-item Likert-scale questionnaire was completed by 1193 patients. General satisfaction items were removed from the set, and responses to remaining items underwent factor analysis. Subscales were produced from items representing each factor. Reliability and validity of each subscale were examined. RESULTS. Five subscales with a total of 40 items resulted from the factor analysis: doctors, access, nurses, appointments and facilities. Each subscale was internally reliable (Cronbach's alpha coefficient between 0.73 and 0.95), and initial tests of validity suggested that all subscales were valid. CONCLUSION. The study has resulted in a 40-item scale that has been found to be reliable and valid after initial tests. Further work to test the reliability and validity of the final version of the patient satisfaction questionnaire is described.     

Validation of the Korean Version of Schedule of Fatigue and Anergia: General Physician Questionnaire

The Schedule of Fatigue and Anergy/General Physician (SOFA/GP) was developed to screen for prolonged fatigue in the primary care setting. We aimed to evaluate the reliability and validity of the Korean version of the SOFA/GP (SOFA/GP-K), which is adapted from the original English version. We performed translation and back translation, and after conducting a pilot study, we tested the final version of the questionnaire for its reliability and validity in a Korean primary care setting. Two hundred participants that visited a health examination center in a university hospital completed the survey between September and November 2012. A second survey was performed within 2 weeks of the primary survey to test for reliability. We evaluated concurrent validity between the SOFA/GP-K score, the Fatigue Severity Scale (FSS), and Brief Fatigue Index (BFI) scores. The Spearman correlation coefficient between SOFA/GP-K and FSS was 0.71 and 0.61 between SOFA/GP-K and BFI. Internal consistency of SOFA/GP-K was observed (Cronbach''s alpha = 0.82) and construct validity was confirmed by factor analysis. The Kappa scores for test-retest reliability for each survey item were between 0.28 and 0.64. The SOFA/GP-K is a valid and reliable questionnaire for screening fatigue in a primary care setting.     

A pilot study of community-based training of hospital obstetric senior house officers.

Most senior house officer (SHOs) posts have little relevance to general practice. This problem was addressed in a pilot community teaching placement, of up to one session per week over four to six months that was set up to learn community-based obstetrics from primary health care teams. The nine participating SHOs were interviewed; qualitative analysis revealed seven themes that were important to the SHOs that should help guide further community-based teaching. Such sessional release for improving the practice-based component of vocational training merits evaluation in a larger study.     

Not for resuscitation: more harm than good?

Advance directives such as do not resuscitation orders are becoming more common place in Irish Hospitals. A questionnaire was completed by all 44 interns working in St James' Hospital in January 2010 and by 49/50 Senior House Officers in June 2010.3/44 of interns (6%) and 5/49 (10%) SHO believe that there is no difference between palliative patients and NFR patients. 41/44 interns (93%) and 40/49 of SHOs (81%) believe that attitudes of treating staff change once a patient is listed as NFR. 14/44 of Interns (32%) and 15/49 SHOs (31%) think that nursing staff are reluctant to request a review when these patients become unwell. They were asked if someone listed as NFR became unwell, what would be an appropriate intervention using a grading system. Interns and SHOs appeared to be reluctant to make basic interventions such as blood tests, blood cultures or even oral antibiotics in this sub group of patients. This questionnaire demonstrates that NFR patients are potentially treated differently and possibly under treated by Junior Doctors. The question remains how to balance the best interests of the patient. If NFR status results in under treatment does it cause more harm than good.     

Development of a questionnaire to assess patients'' satisfaction with consultations in general practice.

The assessment of patient satisfaction has become an important concern in the evaluation of health services. Measures of satisfaction must be valid and reliable if they are to be used widely. This paper reports the development of a new questionnaire to assess patients' satisfaction with consultations together with initial tests of the questionnaire's reliability and validity. Principal components analysis of the patients' assessments of care revealed three factors of satisfaction: the professional aspects of the consultation, the depth of the patient's relationship with the doctor, and the perceived length of the consultation. The consultation satisfaction questionnaire is reliable under the conditions of this study and may have a role in research, medical education and audit.     

The development and internal consistency of the satisfaction with Antipsychotic Medication Scale

BACKGROUND: Satisfaction with antipsychotic medication is an important outcome variable. To date, there is a lack of a well-established measure to quantify patient satisfaction with psychiatric medication. This paper describes the development, dimensionality, reliability and validity of the Satisfaction with Antipsychotic Medication (SWAM) scale. METHOD: Clinical and academic experts devised a 33-item Likert scale satisfaction questionnaire. Following a pilot study in a sample of 69 people with schizophrenia, 315 people with schizophrenia on the caseload of local mental health services in three London boroughs completed the questionnaire. The dimensionality, internal consistency and validity of the devised instrument were assessed. RESULTS: Reliability of the SWAM scale was good for subscales and total scores. The alpha coefficient for the two subscales: treatment acceptability and medication insight were 0.92 and 0.84 respectively. The a coefficient for the SWAM scale total score was 0.91 and ranged from 0.92 to 0.90. CONCLUSION: Testing of the psychometric properties of the SWAM scale demonstrate that it is a reliable instrument for measuring patient satisfaction with antipsychotic medication. The measure could be used in routine clinical practice in mental health services to assess patient satisfaction with psychiatric medication.     

Four years' experience of a senior house officer rotation in general medicine including general practice.

A four-month post in general practice was included as an option available to doctors applying for a year-long medical senior house officer (SHO) rotation since August 1993. This study sought the views of SHOs before and after undertaking the general practice post. SHOs gained an understanding of modern general practice and changed their views about certain aspects of general practice. They reported gaining a range of generic skills, which included communication, consultation, and clinical skills. These perceived benefits suggest that such experience merits wider adoption and further evaluation.     

A new GP with special interest headache service: observational study

BACKGROUND: There is poor access to neurology services for patients in the community. AIM: To describe the training of GPs with special interest (GPwSI) in headache and the setting up of a GPwSI clinic in general practice, and report on a comparison with the existing neurology service in terms of case severity, patient satisfaction, and cost. DESIGN OF STUDY: New service provision and evaluation by a questionnaire survey. SETTING: General practice and hospital neurology service in inner-city London. METHOD: The intervention involved training GPs as GPwSIs and setting up a GP headache service. A questionnaire survey was conducted, measuring headache impact, satisfaction, and cost estimates. RESULTS: Headache impact was not significantly different between the two groups of patients, referred to hospital and to a GPwSI. Patients were significantly more satisfied with the GPwSI service, particularly that the service was effective in helping to relieve their symptoms (89% versus 76%; adjusted odds ratio=7.7; 95% confidence interval=2.7 to 22.4). The cost per first appointment was estimated to be pound sterling 136, with pound sterling 68 for subsequent contacts. These are lower than costs for neurologist contacts. CONCLUSION: GPwSI services can satisfy the needs of patients with similar headache impact at costs that are lower than those for secondary care services.     

问题解决问卷(PSI)中文版在大学生中使用的信效度研究

目的:评估问题解决问卷(PSI)中文版在大学生中使用的信度和效度。方法:按班级整群抽取长沙市某大学387名大学生,运用PSI中文版、一般自我效能感量表(GSES)、Beck抑郁自评问卷(BDI)进行调查;随机抽取43人2周后应用PSI中文版进行重测。结果:量表的Cronbach’sα系数为0.810,重测相关系数为0.788,与GSES相关系数为-0.549,以BDI区分有、无抑郁症状组,不同组间PSI评分差异有统计学意义。结论:问题解决问卷中文版具有较好的信度和效度,可应用于大学生问题解决测评。     

What type of general practice do patients prefer? Exploration of practice characteristics influencing patient satisfaction.

BACKGROUND: General practice is currently experiencing a large number of developments. Studies of patient satisfaction are required to guide the changes that many general practitioners are introducing. AIM: A study set out to examine the characteristics of general practices that influence patient satisfaction. METHOD: In 1991-92, a surgery satisfaction questionnaire of demonstrated reliability and validity was administered to 220 patients in each of 89 general practices. A further questionnaire completed by a member of practice staff collected information about practice characteristics including total list size, number, age and sex of practice partners, training status, fundholding status, presence of a practice manager and whether there was a personal list system. Stepwise multiple regression analyses were undertaken to identify those practice characteristics that influenced patient satisfaction. RESULTS: The mean of the response rates of patients completing questionnaires in each practice was 82%. An increasing total list size of patients registered with practices was associated with decreasing levels of general satisfaction and decreased satisfaction with accessibility, availability, continuity of care, medical care and premises. The presence of a personal list system was associated with increased levels of general satisfaction and increased satisfaction with accessibility, availability, continuity of care and medical care. Training practices were associated with decreased levels of general satisfaction and decreased satisfaction with availability and continuity of care. CONCLUSION: The patients of practices in this study preferred smaller practices, non-training practices and practices that had personal list systems. Practice organization should be reviewed in order to ensure that the trend towards larger practices that provide a wider range of services does not lead to a decline in patient satisfaction. General practitioners should have personal list systems and consider the creation of several personal teams within the practice consisting of small numbers of doctors, receptionists and practice nurses.     

关节镜治疗臀肌筋膜挛缩症术后患者满意度调查

目的：研究关节镜微创治疗臀肌筋膜挛缩症术后患者总体满意度和手术优良率情况,以及探究影响术后满意度的因素。方法：搜集南京军区南京总医院2014年9月至2016年1月期间(出院3个月以上),在我院进行关节镜下臀肌筋膜松解术的患者资料,通过回访,邀请其填写调查问卷。并对收集到的92例问卷结果进行多种统计学方法分析,从而得到患者术后满意度,并分析其相关影响因素。结果：关节镜微创治疗臀肌筋膜挛缩症术后患者总体满意度为96.74%(89/92),术后恢复优良率为92.39%(85/92)。影响术后患者满意度的因素包括患者精神健康状况(Z=?2.079,P=0.038)、患者受教育程度(B=1.094,P=0.045),术后功能锻炼(B=2.679,P=0.009),术后症状缓解程度(B=3.568,P<0.001),医护态度(B=2.862,P=0.015),住院感受(B=2.904,P=0.016)。进一步通过因子分析(KMO=0.797,P<0.01)可知第一主成分主要与术后功能锻炼(0.855)、术后症状缓解程度(0.807)、住院感受(0.798)较为密切;第二主成分主要与患者受教育程度(0.990)较为密切。结论：关节镜微创治疗臀肌筋膜挛缩症术后疗效值得肯定,患者术后满意度与受教育程度、精神健康状况、症状缓解程度、术后功能锻炼、住院感受和医护态度等相关。受教育程度越高,总体满意度越高;另外,相比于其他因素,术后功能锻炼和症状缓解程度对患者的术后满意度影响最大,术后功能锻炼的依从性越好,症状缓解的越彻底,则患者的术后满意度越高。     

Predictors of the provision of intrapartum care by general practitioners: five-year cohort study.

BACKGROUND: There is little published evidence that any aspect of vocational training for general practice improves the quality of care provided by general practitioners (GPs). AIM: To investigate whether aspects of education and vocational training predict whether GPs provide intrapartum care. METHOD: A five-year prospective cohort study was carried out in the United Kingdom (UK) using responders to a 1990 national survey of GPs for whom a current UK address could be found. Main outcome measures were factors associated with provision of GP intrapartum care in 1995. RESULTS: In 1995, a minority of ex-trainees (65 out of 349, 18%) provided intrapartum care as GPs, although 28% would ideally have wished to do so; 8% provided home delivery care. Four education and training variables were associated with ex-trainees booking women for GP delivery in 1995: the number of partners in the ex-trainee's GP training practice providing GP intrapartum care (odds ratio (OR) = 1.30); performing forceps deliveries as an obstetric senior house officer (SHO) (OR = 1.24), witnessing episiotomies as a student (OR = 1.17), and witnessing twin deliveries as a student (OR = 0.75). CONCLUSIONS: In the case of GP intrapartum care, future service provision is associated with certain education and training variables. There is a mismatch between GPs' ideal and actual maternity care provision. Changes to enhance such care would be needed at least at three levels: selection and approval of training practices, content and base for SHO posts, and practice arrangements for maternity cover.     

Career progress of temporary lecturers in anatomy: A surgical success story

A questionnaire concerning career progress was sent to 159 previous holders of temporary lecturer posts in anatomy (TLAs) at the University of Manchester (UK) between 1975 and 1992. Replies were received from 123 TLAs, of whom 90% were male and 71% had achieved Fellowship(s) of a Royal College of Surgeons. Of the 86 respondents who had reached career appointments, 72% held surgical posts, 16% were in general practice, 6% were in nonsurgical hospital specialties, and 6% in nonclinical careers. The duration of training for the surgical specialties overall had been 12 years. Postgraduate diplomas and degrees had been obtained by 93% of career post holders. Most respondents (87%) had found the posts to be useful for their ongoing careers, citing improved communication skills and teaching. The positive values of temporary lecturer posts in anatomy are discussed in relation to the declining numbers of medically qualified anatomists, and the implications of changes in postgraduate surgical training in the UK are highlighted. Clin. Anat. 11:50–54, 1998. © 1998 Wiley-Liss, Inc.     

Diagnosing the doctors' departure: survey on sources of dissatisfaction among Irish junior doctors

There has been a significant decline in the number of applications for non-consultant hospital doctor (NCHD) posts in Ireland over the last 18 months. We conducted an online, anonymous survey of Irish NCHDs to establish levels of satisfaction, sources of dissatisfaction and the major reasons for junior doctors seeking work abroad. 522 NCHDs took the survey, including 64 (12.3%) currently working outside of the Republic. 219 (45.8%) were slightly dissatisfied and 142 (29.7%) were extremely dissatisfied with practising medicine in Ireland. Major sources of dissatisfaction included the state of the health care system, staffing cover for leave and illness, the dearth of consultant posts and the need to move around Ireland. The most important reason for NCHDs wishing to leave was to seek better training and career opportunities abroad.     

Royal jelly consumption and hypersensitivity in the community

Background Royal jelly consumption has recently been linked with acute asthma, anaphylaxis and death. A cross-sectional survey was conducted to detennine the prevalence of and the relationship between royal jelly consumption and hypersensitivity reactions. Methods 1472 hospital employees of a teaching hospital in Hong Kong completed a questionnaire on royal jelly consumption and related allergic symptoms, and 176 questionnaire respondents and 300 consecutive asthma clinic patients were skin tested to royal jelly. Results Royal jelly consumption was high, with 461 out of 1472 subjects (31.3%) having taken royal jelly in the past. A total of nine subjects reported 14 adverse reactions to royal jelly, including urticaria, eczema, rhinitis and acute asthma. Thirteen out of 176 questionnaire respondents (7.4%) and 23 out of 300 consecutive asthma clinic attendees (7.3%) had positive skin test to pure royal jelly. All but one of the 36 subjects with positive royal jelly skin test were atopic to other common allergens. Positive associations were found between positive royal jelly skin test and atopy (OR = 33.73, 95% CI 4.51 to 252.11), adverse reactions to royal jelly and a history of clinical allergy (OR = 2.88, 95% CI 0.72 to 11.58), but not between royal jelly symptoms and previous royal jelly intake. Conclusion Royal jelly consumption is high in the community of Hong Kong. Atopic individuals are at high risk of sensitization to royal jelly but the precise relationship between royal jelly use, positive royal jelly skin test and clinical manifestations of adverse reactions to royal jelly, remains to be defined.     

士兵训练倦怠自评问卷信度及效度的验证

目的:编制士兵训练倦怠自评问卷,并对其信度、效度进行验证。方法:随机整群抽取968名士兵为研究对象,分A(485名)、B(483名)两个组。用编制的士兵训练倦怠自评问卷对两组数据进行测查。A组进行探索性因素分析和相关分析,B组进行验证性因素分析。结果:经检验,问卷Cronbach'sα系数为0.778,各因子的Cronbach'sα系数范围0.670~0.721;问卷的折半信度为0.754,各维度间的折半系数为0.654~0.680。问卷维度间相关系数0.312~0.486(P0.01),各维度与问卷总分间相关系数为0.663~0.785(P0.01)。经探索性因素分析和验证性因素分析发现,问卷结构和理论模型与新兵训练倦怠自评问卷一致,问卷的一阶三因素模型(χ2/df=3.548,GFI=0.959、AGFI=0.938、NFI=0.911、CFI=0.934、IFI=0.934、RMSEA=0.058)拟合效果比较理想。问卷总分及3个维度与职业倦怠总分及各维度呈显著正相关(P0.01)。结论:士兵训练倦怠自评问卷具有较好的信效度,可以作为训练倦怠测查工具使用。     

军人一般能力测验的信度及效度分析

目的编制《军人一般能力测验》问卷,并对其进行信效度研究。方法运用重测信度法和pearson相关法计算相关,研究重测信度以及效标关联效度;运用Kaiser标准化的正交旋转法研究结构效度。结果探索性因素分析结果表明,军人一般能力测验量表存在的5个独立维度(KMO=0.78,P0.01);量表的内部一致性系数为0.89,各维度的内部一致性系数介于0.82~0.91之间;问卷中各维度之间具有显著相关(r=0.19~0.67,P0.05),各维度与总分具有很高的相关性(r=0.47~0.78,P0.01),表明量表信度和效度良好。问卷总分与被试年龄无显著相关;问卷各维度与韦氏智力测验相应部分有显著相关(r=0.615~0.977,P0.01);问卷各维度得分与20门学习科目考试成绩有显著相关(r=0.436~0.983,P0.01),表明量表的效标关联效度较好。结论《军人一般能力测验》具有较高的信度和效度,具有一定的实用性。     

4-6年级多重成就测验的编制II:信度考验

目的:以CTT和GT作4-6年级MATs的信度检验。方法:重测信度161例,复本信度180例,重测复本信度200例。项目有效样本2002例,其中A本1004例,B本998例。结果:A、B本分量表和总量表重测信度0.91～0.95,复本信度0.87～0.94,重测复本信度0.82～0.89,分半信度0.79～0.90,系数0.90～0.96,评分者信度0.94～0.98,真分数变异0.82和0.86;概化研究表明分测验条目15个左右为宜,分量表与总量表条目量50与100即可。结论:各种信度考验结果基本符合测量学的计量标准。     

The WOMB (Women's views of birth) antenatal satisfaction questionnaire: development, dimensions, internal reliability, and validity.

BACKGROUND: Antenatal services continue to change, stimulated by the Changing Childbirth report. Women's views should be an important component of assessing the quality of such services. To date, no published quantitative multidimensional assessment instrument has been available to measure their satisfaction with care. AIM: To develop a valid, reliable, multidimensional questionnaire to assess quality of antenatal care. METHOD: A multidimensional satisfaction questionnaire was developed using psychometric methods. Following fieldwork to pilot a questionnaire, three successive versions of it were given by midwives to pregnant women in their final trimester in nine trusts in the old South Western region of England. Their replies were analysed by principal components analysis (PCA) with varimax rotation; internal reliability was assessed by Cronbach's alpha. Face, content, and construct validity were all assessed during development. RESULTS: Out of 196 women, 134 (68.4%) returned the pilot questionnaires. One hundred and seventy-two (57.3%) out of 300 women returned version 1 of the WOMB (WOMen's views of Birth) antenatal satisfaction questionnaire proper, 283 (56.6%) out of 500 returned version 2, and 328 (65.6%) out of 500 returned the final development version. This final version consisted of 11 dimensions in addition to a general satisfaction one. These were [Cronbach's alpha]: five related to antenatal clinic characteristics (travelling to clinic [0.75], waiting at clinic [0.90], clinic environment [0.69], timing of appointment [0.78], car parking [0.85]), three 'professional' characteristics (professional competence [0.80], knowing carers [0.79], information provided [0.81]), antenatal classes [0.76], social support from other pregnant women [0.83], checking for the baby's heart beat [0.63]. There were significant moderate correlations (range = 0.24 to 0.77) between individual dimensions and the general satisfaction dimension. Women's dimension scores were significantly related to age, parity, social class, and best educational achievement. CONCLUSION: This multidimensional satisfaction instrument has good face, content, and construct validity, and excellent internal reliability. It could be used to generally assess antenatal services or to screen them to detect areas where further in-depth qualitative enquiry is merited. Its sensitivity to change over time, external reliability, and transferability to non-Caucasian groups needs to be assessed.