Measuring patients’ experience of nursing quality in acute hospitals: review of existing scales and development and psychometric validation of a new scale

Objective To provide an overview of existing instruments measuring patient-perceived quality of nursing care and to develop and psychometrically evaluate a new multidimensional scale applicable to the German acute care sector.Design We conducted a scale development and validation study involving the...

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Main Authors: Gabriele Meyer, Vera Winter, Kai Svane Blume, Uta Kirchner-Heklau, Steffen Fleischer
Format: Article
Language:English
Published: BMJ Publishing Group 2024-02-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/14/2/e072838.full
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author Gabriele Meyer
Vera Winter
Kai Svane Blume
Uta Kirchner-Heklau
Steffen Fleischer
author_facet Gabriele Meyer
Vera Winter
Kai Svane Blume
Uta Kirchner-Heklau
Steffen Fleischer
author_sort Gabriele Meyer
collection DOAJ
description Objective To provide an overview of existing instruments measuring patient-perceived quality of nursing care and to develop and psychometrically evaluate a new multidimensional scale applicable to the German acute care sector.Design We conducted a scale development and validation study involving the following phases: (1) performing a structured literature search to identify existing scales, (2) generating an initial pool of items using the results of the literature search and expert interviews, (3) coding/categorising the item pool, (4) organising a peer researcher workshop to select relevant items, (5) drafting the survey questionnaire and conducting cognitive pretesting, (6) pilot testing the survey questionnaire, (7) administering the survey to a large sample of hospital patients and (8) conducting a psychometric evaluation comprising exploratory factor analysis using the survey results, followed by confirmatory factor analysis and reliability and validity assessment of the resulting draft scale.Survey participants 17 859 recently hospitalised patients discharged from non-intensive care in non-paediatric and non-psychiatric hospital units in Germany between May and October 2019.Results We identified 32 instruments comprising 635 items on nursing care quality. Alongside 135 indicators derived from expert interviews, these formed our initial item pool, which we coded into 15 categories. From this pool, 36 items were selected in the peer researcher workshop for pretesting and psychometric evaluation. Based on the results of our exploratory and confirmatory factor analyses, we propose a second-order scale to measure Patients’ Experience of Nursing Quality in Acute Hospitals (PENQuAH), including the two higher-order dimensions ‘patients’ perception of direct nursing care activities’ and ‘patients’ perception of guidance provided by nurses’. The results of various tests suggest the scale has sufficient goodness of fit, reliability and validity.Conclusions The PENQuAH scale is promising in terms of its psychometric properties, the plausibility and meaningfulness of its dimensions, and its ease of use.
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spelling doaj.art-ed3e5048d6fc499281ac9b492839fab32024-03-06T08:15:08ZengBMJ Publishing GroupBMJ Open2044-60552024-02-0114210.1136/bmjopen-2023-072838Measuring patients’ experience of nursing quality in acute hospitals: review of existing scales and development and psychometric validation of a new scaleGabriele Meyer0Vera Winter1Kai Svane Blume2Uta Kirchner-Heklau3Steffen Fleischer4Institute for Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), GermanySchumpeter School of Business and Economics, University of Wuppertal, Wuppertal, GermanySchumpeter School of Business and Economics, University of Wuppertal, Wuppertal, GermanyInstitute for Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), GermanyInstitute for Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), GermanyObjective To provide an overview of existing instruments measuring patient-perceived quality of nursing care and to develop and psychometrically evaluate a new multidimensional scale applicable to the German acute care sector.Design We conducted a scale development and validation study involving the following phases: (1) performing a structured literature search to identify existing scales, (2) generating an initial pool of items using the results of the literature search and expert interviews, (3) coding/categorising the item pool, (4) organising a peer researcher workshop to select relevant items, (5) drafting the survey questionnaire and conducting cognitive pretesting, (6) pilot testing the survey questionnaire, (7) administering the survey to a large sample of hospital patients and (8) conducting a psychometric evaluation comprising exploratory factor analysis using the survey results, followed by confirmatory factor analysis and reliability and validity assessment of the resulting draft scale.Survey participants 17 859 recently hospitalised patients discharged from non-intensive care in non-paediatric and non-psychiatric hospital units in Germany between May and October 2019.Results We identified 32 instruments comprising 635 items on nursing care quality. Alongside 135 indicators derived from expert interviews, these formed our initial item pool, which we coded into 15 categories. From this pool, 36 items were selected in the peer researcher workshop for pretesting and psychometric evaluation. Based on the results of our exploratory and confirmatory factor analyses, we propose a second-order scale to measure Patients’ Experience of Nursing Quality in Acute Hospitals (PENQuAH), including the two higher-order dimensions ‘patients’ perception of direct nursing care activities’ and ‘patients’ perception of guidance provided by nurses’. The results of various tests suggest the scale has sufficient goodness of fit, reliability and validity.Conclusions The PENQuAH scale is promising in terms of its psychometric properties, the plausibility and meaningfulness of its dimensions, and its ease of use.https://bmjopen.bmj.com/content/14/2/e072838.full
spellingShingle Gabriele Meyer
Vera Winter
Kai Svane Blume
Uta Kirchner-Heklau
Steffen Fleischer
Measuring patients’ experience of nursing quality in acute hospitals: review of existing scales and development and psychometric validation of a new scale
BMJ Open
title Measuring patients’ experience of nursing quality in acute hospitals: review of existing scales and development and psychometric validation of a new scale
title_full Measuring patients’ experience of nursing quality in acute hospitals: review of existing scales and development and psychometric validation of a new scale
title_fullStr Measuring patients’ experience of nursing quality in acute hospitals: review of existing scales and development and psychometric validation of a new scale
title_full_unstemmed Measuring patients’ experience of nursing quality in acute hospitals: review of existing scales and development and psychometric validation of a new scale
title_short Measuring patients’ experience of nursing quality in acute hospitals: review of existing scales and development and psychometric validation of a new scale
title_sort measuring patients experience of nursing quality in acute hospitals review of existing scales and development and psychometric validation of a new scale
url https://bmjopen.bmj.com/content/14/2/e072838.full
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