Understanding and measuring patients' assessment of the quality of nursing care.

BACKGROUND: Traditionally, patients have been considered incapable of evaluating the quality of care they receive, leading to their minimal involvement.

OBJECTIVE: To develop the Patient's Assessment of Quality Scale--Acute Care Version (PAQS-ACV) to provide a mechanism through which patients can evaluate meaningfully the nursing care they receive.

METHODS: Developed from qualitative interviews with patients, the original 90-item PAQS-ACV was tested with 1,470 medical surgical patients in 43 units across seven hospitals. The typical patient was a married, 50-year-old, high school-educated patient hospitalized for the fourth time. Every 10th patient was asked to complete the PAQS-ACV 2 weeks later.

RESULTS: After exploratory factor analysis, 45 items remained in five factors, accounting for 54% of the variance. Internal consistency estimates were above.83 for four of the five factors, with the fifth factor being.68. Test-retest reliability ranged from .58 to .71. Content validity was established and construct validity has been explored preliminarily by examining the relationship between the PAQS-ACV scores and patients' compliance.

DISCUSSION: Although the PAQS-ACV is a relatively new measure of quality nursing care, it has met many criteria for an adequate measure of quality care. The instrument fills a void in the assessment of quality by including patients in the direct evaluation of the care received.