title: Understanding and measuring patients' assessment of the quality of nursing care.
abstract: 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.
authors.affiliation: School of Nursing, University of North Carolina at Chapel Hill, NC 27599-7460, USA. mary_lynn@unc.edu
authors.forename: Mary R
authors.initials: MR
authors.lastname: Lynn
authors.forename: Bradley J
authors.initials: BJ
authors.lastname: McMillen
authors.forename: Souraya
authors.initials: S
authors.lastname: Sidani
mesh_terms: 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*