Validation of a French hospitalized patients' satisfaction questionnaire: The QSH-45

Abstract

Objective. To develop a generic French self-administered instrument for measuring hospitalized patients' satisfaction based on the patient's point of view: the questionnaire for satisfaction of hospitalized (QSH) patients. Design. The development was supervised by a steering committee and undertaken through three standard steps. Item generation was derived from 95 face-to-face interviews, performed in hospitalized patients and in patients scheduled to be admitted. The item reduction led to a 69-item questionnaire. The validation process was based on validity, reliability and some aspects of external validity. Setting. Medical, surgical and obstetrical departments (n = 187) of public hospitals (n = 11) from different French regions (n = 3). Participants. Eligible patients were adult subjects hospitalized for at least 24 h. Main outcome measures. QSH, sociodemographic data, hospitalization department, visual analogue scales of satisfaction. Results. The final version of QSH contained 45 items describing 9 dimensions, leading to 2 composite scores (staff and structure index). The factor structure accounted for 71% of the total variance. Internal consistency was satisfactory (item-internal consistency over 0.40; Cronbach's alpha coefficients ranged from 0.76 to 0.96). The scalability was satisfactory with inlier-sensitive fit (INFIT) statistics inside an acceptable range. Scores of dimensions were strongly positively correlated with visual analogue scale scores (all P < 0.001). External validity showed statistical associations between QSH scores and age or department. Participation rate was 91%. Conclusions. The availability of a reliable and valid French questionnaire concerning hospitalized patients' satisfaction, exclusively generated from patients' interviews, enables patient feedback to be incorporated in a continuous quality health-care improvement strategy. © The Author 2009. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.