Cross-cultural evaluation of the relevance of the HCAHPS survey in five European countries.
OBJECTIVE
To describe the systematic language translation and cross-cultural evaluation process that assessed the relevance of the Hospital Consumer Assessment of Healthcare Providers and Systems survey in five European countries prior to national data collection efforts.


METHODS
An approach involving a systematic translation process, expert review by experienced researchers and a review by 'patient' experts involving the use of content validity indexing techniques with chance correction.


METHODS
Five European countries where Dutch, Finnish, French, German, Greek, Italian and Polish are spoken.


METHODS
'Patient' experts who had recently experienced a hospitalization in the participating country. Main OutcomeMeasure(s) Content validity indexing with chance correction adjustment providing a quantifiable measure that evaluates the conceptual, contextual, content, semantic and technical equivalence of the instrument in relationship to the patient care experience.


RESULTS
All translations except two received 'excellent' ratings and no significant differences existed between scores for languages spoken in more than one country. Patient raters across all countries expressed different concerns about some of the demographic questions and their relevance for evaluating patient satisfaction. Removing demographic questions from the evaluation produced a significant improvement in the scale-level scores (P= .018). The cross-cultural evaluation process suggested that translations and content of the patient satisfaction survey were relevant across countries and languages.


CONCLUSIONS
The Hospital Consumer Assessment of Healthcare Providers and Systems survey is relevant to some European hospital systems and has the potential to produce internationally comparable patient satisfaction scores.
New York University College of Nursing, New York, NY 10003, USA. aps6@nyu.edu
Allison
A
Squires
Luk
L
Bruyneel
Linda H
LH
Aiken
Koen
K
Van den Heede
Tomasz
T
Brzostek
Reinhard
R
Busse
Anneli
A
Ensio
Maria
M
Schubert
Dimitrios
D
Zikos
Walter
W
Sermeus
D003431:Cross-Cultural Comparison; D005060:Europe; D006302:Health Services Research / Q000379:methods*; D006801:Humans; D017060:Patient Satisfaction; D011594:Psychometrics; D011787:Quality of Health Care; D015203:Reproducibility of Results; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014177:Translations