USE OF THE CONSULTATION SATISFACTION QUESTIONNAIRE TO EXAMINE PATIENTS SATISFACTION WITH GENERAL-PRACTITIONERS AND COMMUNITY NURSES - RELIABILITY, REPLICABILITY AND DISCRIMINANT VALIDITY

Background. Primary health care services are the most frequently used in the health care system. Consumer feedback on these services is impo rtant. Research in this area relates mainly to doctor-patient relation ships which fails to reflect the multidisciplinary nature of primary h ealth care. Aim. A pilot study aimed to examine the feasibility of usi ng a patient satisfaction questionnaire designed for use with general practitioner consultations as an instrument for measuring patient sati sfaction with community nurses. Method. The questionnaire measuring pa tient satisfaction with general practitioner consultations was adapted for measuring satisfaction with contacts with a nurse practitioner, d istrict nurses, practice nurses and health visitors. A total of 1575 p atients in three practices consulting general practitioners or communi ty nurses were invited to complete a questionnaire. Data were subjecte d to principal components analysis and the dimensions identified were tested for internal reliability and replicability. To establish discri minant validity patients' mean satisfaction scores for consultations w ith general practitioners, the nurse practitioner, health visitors and nurses (district and practice nurses) were compared. Results. Ouestio nnaires were returned relating to 400 general practitioner, 54 nurse p ractitioner, 191 district/practice nurse and 83 health visitor consult ations (overall response rate 46%). Principal components analysis demo nstrated a factor structure similar to that found in an earlier study of the consultation satisfaction questionnaire. Three dimensions of pa tient satisfaction were identified: professional care, depth of relati onship and perceived time spent with the health professional. The dime nsions were found to have acceptable levels of reliability. Factor str uctures obtained from data relating to general practitioner and commun ity nurse consultations were found to correlate significantly. Compari son between health professionals showed that patients rated satisfacti on with professional care significantly more highly for nurses than fo r general practitioners and health visitors. Patients' ratings of sati sfaction with the depth of relationships with health visitors was sign ificantly 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 sat isfaction with the perceived amount of time spent with health professi onals. Conclusion. The pilot study showed that it is possible to use t he consultation satisfaction questionnaire for both general practition ers and community nurses. Comparison between health professional group s should be undertaken with caution as data were available for only a small number of consultations with some of the groups of health profes sionals studied.