Development of scales to measure satisfaction and preferences regarding long-term and terminal care

Abstract

This report describes efforts to develop and test scales for measuring attitudes toward the medical care of chronically and terminally ill patients and their families. The following satisfaction scales were developed: General Satisfaction, Availability of Care, Continuity of Care, Physician Availability, Physician Competence, Personal Qualities of Physician, Communication with Physician, Involvement of Patient and Family in Treatment Decisions, Freedom from Pain, and Pain Control. Preference scales were developed to measure preference for home care and preference for physician decisions. These scales were tested in two independent study samples: Home Care Study subjects--patients and their caretakers enrolled in a trial to evaluate a new method of home care for chronically and terminally ill homebound patients; and Terminal Care Study subjects--surviving relatives of a random sample of cancer patients who died. The internal consistency, discriminant validity, and convergent validity of each scale were assessed by means of item-total correlations, Cronbach 's alpha, and comparison with other questionnaire items. The results supported the use of several scales in their original form. Recommendations are made for appropriate modifications in the remaining scales.