Validation of a questionnaire measuring patient satisfaction with general practitioner services S Grogan, M Conner, P Norman, D Willits, I Porter Abstract Background—In order that patient satis- faction may be assessed in a meaningful way, measures that are valid and reliable are required. This study was undertaken to assess the construct validity and inter- nal reliability of the previously developed Patient Satisfaction Questionnaire (PSQ). Method—A total of 1390 patients from five practices in the North of England, the Midlands, and Scotland completed the questionnaire. Responses were checked for construct validity (including con- firmatory factor analysis to check the fac- tor structure of the scale) and internal reliability. Results—Confirmatory factor analysis showed that items loaded on the appropri- ate factors in a five factor model (doctors, nurses, access, appointments, and facili- ties). Scores on the specific subscales showed highly significant positive correla- tions with general satisfaction subscale scores suggesting construct validity. Also, the prediction (derived from past re- search) that older people would be more satisfied with the service was borne out by the results (F (4, 1312) = 57.10; p<0.0001), providing further construct validation. The five specific subscales (doctors, nurses, access, appointments, and facili- ties), the general satisfaction subscale, and the questionnaire as a whole were found to have high internal reliability (Cronbach’s  = 0.74–0.95). Conclusion—The results suggest that the PSQ is a valid and internally reliable tool for assessing patient satisfaction with gen- eral practitioner services. (Quality in Health Care 2000;9:210–215) Keywords: patient satisfaction; general practitioner services; questionnaire construction; construct validity; reliability Assessment of patient satisfaction allows gen- eral practitioners to investigate the extent to which their service meets the needs of their cli- ent group. 1 Questionnaires that assess specific aspects of service provision will enable the practitioner to identify aspects of the service where patients are less satisfied, and potentially improve these aspects of care. 2 Research has shown that satisfied patients are more likely to follow treatment instructions and medical advice, probably because they are more likely to believe that treatment will be eVective. 3 They are also less likely to change doctors and file formal complaints. 4 It is therefore in the general practitioner’s interest to know the extent of patient satisfaction with service provision. 5 Over the last 10 years there has been increased interest in investigating patient satis- faction with quality of care. Assessing patient satisfaction was a requirement of the 1990 contract for general practitioners in Britain 6 and more and more practices are surveying patient satisfaction with service provision. 78 The recent Department of Health publication “Our Healthier Nation” emphasised the importance of obtaining patients’ views as a way of improving services. 9 In order that satis- faction can be assessed in a meaningful way, it is important to develop valid and reliable measures that give practices the information that they need to assess the quality of the proc- ess and outcome of care. 10 Baker 11 argues that a worthwhile patient sat- isfaction scale must fulfil three requirements: it must be reliable (produce consistent results), valid (measure what it is designed to test), and show transferability (measure the same con- structs when applied to diVerent patient groups). In 1995 we reported the development of a multidimensional scale derived from in depth interviews with patients designed to assess patient satisfaction with all aspects of the general practitioner service. 12 The scale im- proved on previous measures of patient satis- faction with general practitioners’ services 13 by incorporating all aspects of care into one ques- tionnaire, rather than assessing satisfaction Key messages + It is in the interest of general practitioners to know the extent of patient satisfaction with the service they are providing. + To assess satisfaction in a meaningful way, valid and reliable measures must be developed that give practices the infor- mation needed to asses the quality of the process and outcome of care. + A worthwhile patient satisfaction scale must be internally reliable, construct valid, and show transferability. + The previously developed Patient Satis- faction Questionnaire (PSQ) was tested in 1390 patients from five practices in diVerent geographical areas of the UK and was found to fulfil these three criteria. + The PSQ is a useful tool for assessing patient satisfaction with service provision to help general practices determine how well they are meeting the needs of their patients. Quality in Health Care 2000;9:210–215 210 Department of Psychology and Speech Pathology, Manchester Metropolitan University, Elizabeth Gaskell Building, Manchester M13 0JA S Grogan, senior lecturer School of Psychology, University of Leeds, Leeds LS2 9JT M Conner, senior lecturer Department of Psychology, University of SheYeld, SheYeld S10 2TP P Norman, senior lecturer Staithe Surgery, Lower Staithe, Sutton, Norwich NR12 9BU D Willits, general practitioner Radical Department, North Mersey Community Trust, Mossley Hill Hospital, Liverpool L18 8BU I Porter, research and development head Correspondence to: Dr S Grogan s.grogan@mmu.ac.uk Accepted 3 October 2000 www.qualityhealthcare.com