title: The telehealth satisfaction scale: reliability, validity, and satisfaction with telehealth in a rural memory clinic population.
abstract: BACKGROUND
  Patient satisfaction is a key aspect of quality of care and can inform continuous quality improvement. Of the few studies that have reported on patient satisfaction with telehealth in programs aimed at individuals with memory problems, none has reported on the psychometric properties of the user satisfaction scales used.
  
  
  METHODS
  We evaluated the construct validity and internal consistency reliability of the Telehealth Satisfaction Scale (TeSS), a 10-item scale adapted for use in a rural and remote memory clinic (RRMC). The RRMC is a one-stop interprofessional clinic for rural and remote seniors with suspected dementia, located in a tertiary-care hospital. Telehealth videoconferencing is used for preclinic assessment and for follow-up. Patients and caregivers completed the TeSS after each telehealth appointment. With data from 223 patients, exploratory factor analysis was conducted using the principal components analysis extraction method.
  
  
  RESULTS
  The eigenvalue for the first factor (5.2) was greater than 1 and much larger than the second eigenvalue (0.92), supporting a one-factor solution that was confirmed by the scree plot. The total variance explained by factor 1 was 52.1%. Factor loadings (range, 0.54-0.84) were above recommended cutoffs. The TeSS items demonstrated high internal consistency reliability (Cronbach's alpha=0.90). Satisfaction scores on the TeSS items ranged from 3.43 to 3.72 on a 4-point Likert scale, indicating high satisfaction with telehealth.
  
  
  CONCLUSIONS
  The study findings demonstrate high user satisfaction with telehealth in a rural memory clinic and the sound psychometric properties of the TeSS in this population.
authors.affiliation: 1 Canadian Centre for Health & Safety in Agriculture, College of Medicine, University of Saskatchewan , Saskatoon, Saskatchewan, Canada.
authors.forename: Debra G
authors.initials: DG
authors.lastname: Morgan
authors.forename: Julie
authors.initials: J
authors.lastname: Kosteniuk
authors.forename: Norma
authors.initials: N
authors.lastname: Stewart
authors.forename: Megan E
authors.initials: ME
authors.lastname: O'Connell
authors.forename: Chandima
authors.initials: C
authors.lastname: Karunanayake
authors.forename: Rob
authors.initials: R
authors.lastname: Beever
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011594:Psychometrics; D058996:Quality Improvement; D015203:Reproducibility of Results; D019035:Rural Health Services / Q000458:organization & administration*; D012424:Rural Population; D012525:Saskatchewan; D049269:Videoconferencing
keywords: dementia; memory clinic; psychometric; reliability; rural; satisfaction with telehealth; scale; validity