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      Development and content validation of the Telenursing Interaction and Satisfaction Questionnaire (TISQ)

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          Abstract

          Background

          Caller satisfaction with telephone advice nursing (TAN) is generally high, and the interaction is essential. However, a valid questionnaire exploring caller satisfaction in TAN with focus on perceived interaction is lacking.

          Objective

          To develop and assess content validity and test‐retest reliability of a theoretically anchored questionnaire, the Telenursing Interaction and Satisfaction Questionnaire (TISQ), that explores caller satisfaction in TAN by focusing on perceived interaction between the caller and the telenurse.

          Methods

          The study was performed in three stages. First, variables relevant for patient satisfaction in health care were identified through a literature search. Variables were then structured according to the Interaction Model of Client Health Behavior (IMCHB), which provided theoretical guidance. Items relevant for a TAN context were developed through consensus discussions. Then, evaluation and refinement were performed through cognitive interviews with callers and expert ratings of the Content Validity Index (CVI). Finally, test‐retest reliability of items was evaluated in a sample of 109 individuals using intraclass correlation coefficients (ICC).

          Results

          The TISQ consists of 60 items. Twenty items cover perceived interaction in terms of health information, affective support, decisional control and professional/technical competence. Five items cover satisfaction with interaction and five items overall satisfaction. Remaining items reflect singularity of the caller and descriptive items of the call. The TISQ was found to exhibit good content validity, and test‐retest reliability was moderate to good (ICC = 0.39‐0.84).

          Conclusions

          The items in the TISQ form a comprehensive and theoretically anchored questionnaire with satisfactory content validity and test‐retest reliability.

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          Most cited references16

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          Determination and quantification of content validity.

          M Lynn (1986)
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            Patient satisfaction: a review of issues and concepts.

            This review presents issues arising from an analysis of over 100 papers published in the field of patient satisfaction. The published output appearing in the medical and nursing literature which incorporated the term "patient satisfaction" rose to a peak of over 1000 papers annually in 1994, reflecting changes in service management especially in the U.K. and U.S.A. over the past decade. An introductory section discusses the setting and measurement of patient satisfaction within this wider context of changes in service delivery. Various models are examined that have attempted to define and interpret the idea of determining individual perceptions of the quality of health care delivered. Determinants of satisfaction are examined in relation to the literature on expectations, and demographic and psychosocial variables. These are distinguished from the multidimensional components of satisfaction as aspects of the delivery of care, identified by many authors. The review highlights the complexity and breadth of the literature in this field, the existence of which is often not acknowledged by researchers presenting the findings of studies.
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              Predictors of patient satisfaction.

              Correlates of patient satisfaction at varying points in time were assessed using a survey with 2-week and 3-month follow-up in a general medicine walk-in clinic, in USA. Five hundred adults presenting with a physical symptom, seen by one of 38 participating clinicians were surveyed and the following measurements were taken into account: patient symptom characteristics, symptom-related expectations, functional status (Medical Outcomes Study Short-Form Health Survey [SF-6]), mental disorders (PRIME-MD), symptom resolution, unmet expectations, satisfaction (RAND 9-item survey), visit costs and health utilization. Physician perception of difficulty (Difficult Doctor Patient Relationship Questionnaire), and Physician Belief Scale. Immediately after the visit, 260 (52%) patients were fully satisfied with their care, increasing to 59% at 2 weeks and 63% by 3 months. Patients older than 65 and those with better functional status were more likely to be satisfied. At all time points, the presence of unmet expectations markedly decreased satisfaction: immediately post-visit (OR: 0.14, 95% CI: 0.07-0.30), 2-week (OR: 0.07, 95% CI: 0.04-0.13) and 3-month (OR: 0.05, 95% CI: 0.03-0.09). Other independent variables predicting immediate after visit satisfaction included receiving an explanation of the likely cause as well as expected duration of the presenting symptom. At 2 weeks and 3 months, experiencing symptomatic improvement increased satisfaction while additional visits (actual or anticipated) for the same symptom decreased satisfaction. A lack of unmet expectations was a powerful predictor of satisfaction at all time-points. Immediately post-visit, other predictors of satisfaction reflected aspects of patient doctor communication (receiving an explanation of the symptom cause, likely duration, lack of unmet expectations), while 2-week and 3-month satisfaction reflected aspects of symptom outcome (symptom resolution, need for repeat visits, functional status). Patient satisfaction surveys need to carefully consider the sampling time frame as well as adjust for pertinent patient characteristics.
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                Author and article information

                Contributors
                Role: doctoral studentmarie.mattisson@liu.se
                Role: Licentiate of Medical Science
                Role: Professor
                Role: Professor
                Role: Ass. Professor
                Journal
                Health Expect
                Health Expect
                10.1111/(ISSN)1369-7625
                HEX
                Health Expectations : An International Journal of Public Participation in Health Care and Health Policy
                John Wiley and Sons Inc. (Hoboken )
                1369-6513
                1369-7625
                12 September 2019
                December 2019
                : 22
                : 6 ( doiID: 10.1111/hex.v22.6 )
                : 1213-1222
                Affiliations
                [ 1 ] Department of Medical and Health Sciences Linköping University Linköping Sweden
                [ 2 ] 1177 Medical Advisory Service and Department of Medical and Health Sciences Linköping University Linköping Sweden
                [ 3 ] Faculty of Health and Life Sciences Linnaeus University Kalmar Sweden
                [ 4 ] The Research Section Kalmar County Council Kalmar Sweden
                Author notes
                [*] [* ] Correspondence

                Marie Mattisson, Department of Social and Welfare Studies (ISV), Linköping University, Campus Norrköping, 601 74 Norrköping, Sweden.

                Email: marie.mattisson@ 123456liu.se

                Author information
                https://orcid.org/0000-0001-5033-0874
                Article
                HEX12945
                10.1111/hex.12945
                6882254
                31513328
                71588be7-5661-4b37-8b22-3df4ad850973
                © 2019 The Authors Health Expectations published by John Wiley & Sons Ltd

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 11 December 2018
                : 07 May 2019
                : 14 July 2019
                Page count
                Figures: 2, Tables: 1, Pages: 10, Words: 7362
                Funding
                Funded by: Medical Research Council of Southeast Sweden
                Funded by: Östergötland county council
                Categories
                Original Research Paper
                Original Research Papers
                Custom metadata
                2.0
                hex12945
                December 2019
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.7.2 mode:remove_FC converted:28.11.2019

                Health & Social care
                communication,content validity,nurse‐patient relations,patient experiences,patient satisfaction,surveys and questionnaires,telenursing

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