title: Development of an instrument to measure patient perception of the quality of nursing care and related hospital services at the national hospital of sri lanka.
abstract: OBJECTIVE
  This study aimed to develop and validate an instrument to measure patient perception of quality of nursing care and related hospital services in a tertiary care setting.
  
  
  METHODS
  We compiled an instrument with 72 items that patients may perceive as quality of nursing care and related hospital services, following an extensive literature search, discussions with patients and care pro-I viders and a brainstorming session with an expert panel. A cross-sectional study was conducted at the National Hospital of Sri Lanka. A sample (n = 120) of patients stayed in general surgical or medical units responded to the interviewer administered instrument upon discharge. Item analysis and principal component factor analysis were performed to assess validity, and internal consistency was calculated to measure reliability.
  
  
  RESULTS
  Of the 72 items, 18 had greater than 20% of responses as 'not relevant'. A further 11 items were eliminated since item-total correlations were less than .2. Factor analysis was performed on remaining 43 items which resulted in 36 items classifying into eight factors accounting for 71% of the variation. Factor loadings in the final solution after Varimax rotation were interpersonal aspects (.68-.85), efficiency (.62-.79), competency (.66-.68), comfort (.60-.84), physical environment (.65-.82), cleanliness (.81-.85), personalized information (.76-.83), and general instructions (.61-.78). The instrument had high Internal consistency (Cronbach's alpha = .91).
  
  
  CONCLUSIONS
  We developed a comprehensive, reliable and valid, 36-item instrument that may be used to measure patient perception of quality of nursing care in tertiary care settings.
authors.affiliation: Senior Lecturer, Department of Community Medicine, Faculty of Medicine, University of Colombo, Sri Lanka.
authors.forename: Upul
authors.initials: U
authors.lastname: Senarat
authors.forename: Nalika S
authors.initials: NS
authors.lastname: Gunawardena