title: Development and validation of the irritable bowel syndrome satisfaction with care scale.
abstract: OBJECTIVE
  Satisfaction with care is an important measure of quality, from the patients' perspective, and could also affect outcomes. However, there is no standard measure of patient satisfaction for irritable bowel syndrome (IBS) care; a multi-item, condition-specific instrument is needed.
  
  
  METHODS
  Using standard qualitative methods, we conducted focus groups to identify items that patients associated with satisfaction in their care for IBS. These and additional items identified by experts were placed into a preliminary questionnaire, which was refined through pilot testing and cognitive debriefing by additional patients, as well as standard statistical methods. The resulting instrument and several external validation measures were administered to 300 adult US patients with IBS. Factor analysis was performed to identify clinically relevant subscales and then psychometric properties were assessed.
  
  
  RESULTS
  We developed an IBS satisfaction with care scale (IBS-SAT) that has 38 items from 5 clinically relevant subscales (connection with provider, education, benefits of visit, office attributes, and access to care). This IBS-SAT had a high level of internal consistency (Crohnbach's α = .96). Convergent validity was established by correlations between the IBS-SAT and a single, global satisfaction with care question (r = 0.68; P < .001), and a generic, multi-item satisfaction scale (physician satisfaction questionnaire-18) (r = 0.75, P < .001). Discriminant validity (among known groups) was established across groups that were stratified based on IBS-quality of life (r = 0.34; P < .0001), IBS severity (functional bowel disorders severity index) (r = -0.21; P < .001), and number of unmet expectations (r = -0.38; P < .0001).
  
  
  CONCLUSIONS
  The IBS-SAT is a validated measure of patient satisfaction with IBS care. As a new, condition-specific instrument, it is likely to be a useful tool for quality measurement, health services research, and clinical trials.
authors.affiliation: Center for Functional GI and Motility Disorders, University of North Carolina, Chapel Hill, North Carolina 27599-7080, USA. sdorn@med.unc.edu
authors.forename: Spencer D
authors.initials: SD
authors.lastname: Dorn
authors.forename: Carolyn B
authors.initials: CB
authors.lastname: Morris
authors.forename: Susan E
authors.initials: SE
authors.lastname: Schneck
authors.forename: Teresa M
authors.initials: TM
authors.lastname: Hopper
authors.forename: Yuming J B
authors.initials: YJ
authors.lastname: Hu
authors.forename: Renuka
authors.initials: R
authors.lastname: Kelapure
authors.forename: Stephan R
authors.initials: SR
authors.lastname: Weinland
authors.forename: William F
authors.initials: WF
authors.lastname: Norton
authors.forename: Nancy J
authors.initials: NJ
authors.lastname: Norton
authors.forename: Douglas A
authors.initials: DA
authors.lastname: Drossman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D017144:Focus Groups; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000523:psychology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D017060:Patient Satisfaction; D014481:United States