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Development and Testing of a Visit-Specific Patient Satisfaction Questionnaire: The Princess Margaret Hospital Satisfaction With Doctor Questionnaire

D. Andrew Loblaw, Andrea Bezjak, Terry Bunston

From the Departments of Radiation Oncology and Psychosocial Oncology, Princess Margaret Hospital/Ontario Cancer Institute, University of Toronto, Toronto, Ontario, Canada.

Address reprint requests to Andrea Bezjak, MD, Department of Radiation Oncology, Princess Margaret Hospital, 5th Floor, 610 University Ave, Toronto, Ontario, Canada, M5G 2M9; email andrea_bezjak{at}pmh .toronto.on.ca

PURPOSE: To develop a psychometrically sound patient-satisfaction-with-physician questionnaire that can be used in an outpatient oncology setting.

PATIENTS AND METHODS: The questionnaire was developed by a four-step process involving a total of 277 cancer patients. The item-generation process utilized input from 95 oncology outpatients, three medical researchers, and the relevant literature. Items were tested by 70 of the above patients. Initial item reduction was achieved by input from another eight patients. Factor analysis and validity testing used data derived from a different group of 174 oncology outpatients. Convergent validity was tested by correlating the Princess Margaret Hospital Patient Satisfaction with Doctor Questionnaire (PMH/PSQ-MD) with Rubin et al's Physician subscale of the Patient's Viewpoint Questionnaire (PS-PVQ) and Smith et al's Patient-Doctor Interaction Scale (PDIS). Divergent validity was tested by comparing these questionnaires with Spitzer's quality of life (QOL) questionnaire.

RESULTS: The final PMH/PSQ-MD is a 29-item self-administered questionnaire with four response categories and a "does not apply" category. Four domains were confirmed by factor analysis: (1) information exchange, (2) interpersonal skills, (3) empathy, and (4) quality of time. The questionnaire has an overall Cronbach's alpha of 0.97; the values for each domain are, respectively, 0.92, 0.90, 0.88, and 0.88. The PMH/PSQ-MD correlated well with both the PDIS and the PS-PVQ (P < .001 for both). Divergent validity was confirmed with Spitzer's QOL questionnaire.

CONCLUSION: The PMH/PSQ-MD is an outpatient satisfaction questionnaire specific to the patient-physician interaction that has shown excellent internal consistency, is feasible, and has strong support for validity in this oncology population.

This article is dedicated to the memory of Dr Terry Bunston, who passed away unexpectedly September 3, 1998.

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