title: Patient perceptions of caring and association with emergency department activity and access block.
abstract: OBJECTIVE
  To develop and validate a questionnaire isolating patients' perceptions of caring as individuals provided by ED doctors. This tool was then applied to explore the relationship between ED activity and patient perceptions of caring.
  
  
  METHODS
  Following questionnaire development and reliability analysis, a prospective, cross-sectional study was performed of ED patients who completed the written questionnaire regarding perceptions of caring. The ED tracking database obtained demographic data, patient visit characteristics and markers of departmental activity. Spearman's rho evaluated associations between perceptions of caring and activity. Free text responses were analysed thematically.
  
  
  RESULTS
  In reliability testing the questionnaire demonstrated Kappa 0.679, Cronbach's alpha 0.891. The survey was completed by 467 patients. Over 95% of patients agreed that ED doctors: identified themselves; took the problem seriously; treated patients with respect; were courteous and considerate; and demonstrated an overall caring attitude towards patients. Lower agreement occurred with doctors: not distracted by other issues; patient involvement in decisions about care; respect for cultural or religious needs; and doctors going out of their way to help. There were no significant differences in the proportion of patients recruited from different days of the week, shifts or sex. No clinically important associations were demonstrated between perceptions of caring and departmental activity. Least liked aspects of ED care related to system issues rather than the interpersonal relationship with the ED doctors.
  
  
  CONCLUSIONS
  This study has validated a questionnaire isolating caring attributes. ED activity was not associated with patients' perceptions of being cared for by ED doctors.
authors.affiliation: Emergency Department, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia. sarahlimbourn@hotmail.com
authors.forename: Sarah
authors.initials: S
authors.lastname: Limbourn
authors.forename: Antonio
authors.initials: A
authors.lastname: Celenza
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000592:standards*; D005260:Female; D006297:Health Services Accessibility / Q000592:standards / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D005791:Patient Care / Q000523:psychology*; D017060:Patient Satisfaction; D010465:Perception; D011446:Prospective Studies; D011787:Quality of Health Care / Q000592:standards / Q000706:statistics & numerical data*; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D014904:Western Australia; D055815:Young Adult