Understanding and measuring patients' assessment of the quality of nursing care.
BACKGROUND
Traditionally, patients have been considered incapable of evaluating the quality of care they receive, leading to their minimal involvement.


OBJECTIVE
To develop the Patient's Assessment of Quality Scale--Acute Care Version (PAQS-ACV) to provide a mechanism through which patients can evaluate meaningfully the nursing care they receive.


METHODS
Developed from qualitative interviews with patients, the original 90-item PAQS-ACV was tested with 1,470 medical surgical patients in 43 units across seven hospitals. The typical patient was a married, 50-year-old, high school-educated patient hospitalized for the fourth time. Every 10th patient was asked to complete the PAQS-ACV 2 weeks later.


RESULTS
After exploratory factor analysis, 45 items remained in five factors, accounting for 54% of the variance. Internal consistency estimates were above.83 for four of the five factors, with the fifth factor being.68. Test-retest reliability ranged from .58 to .71. Content validity was established and construct validity has been explored preliminarily by examining the relationship between the PAQS-ACV scores and patients' compliance.


CONCLUSIONS
Although the PAQS-ACV is a relatively new measure of quality nursing care, it has met many criteria for an adequate measure of quality care. The instrument fills a void in the assessment of quality by including patients in the direct evaluation of the care received.
Lynn
Mary R
MR
School of Nursing, University of North Carolina at Chapel Hill, NC 27599-7460, USA. mary_lynn@unc.edu
McMillen
Bradley J
BJ
Sidani
Souraya
S
D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D003142:Communication; D004645:Empathy; D005163:Factor Analysis, Statistical; D005260:Female; D006272:Health Facility Environment / Q000592:standards; D006801:Humans; D007206:Individuality; D007297:Inpatients / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009723:Nurse-Patient Relations; D009732:Nursing Care / Q000523:psychology / Q000592:standards; D015403:Nursing Evaluation Research; D015404:Nursing Methodology Research; D010347:Patient Care Planning / Q000592:standards; D010353:Patient Education as Topic / Q000592:standards; D017060:Patient Satisfaction; D011594:Psychometrics; D036301:Qualitative Research; D011787:Quality of Health Care / Q000592:standards*; D012944:Social Support; D011795:Surveys and Questionnaires / Q000592:standards*