Developing Extended EUROPEP Scale And Researching Patients’Satisfaction On GPs In Community

Objective: By introducing the proven EUROPEP-questionnaire (scale for comparingthe service quality of the general medicine and general practice) which is widely usedin the abroad and combined with the actual situations in China, to develop theChinese version of the extended EUROPEP scale, and then evaluate its reliability andvalidity to make it suitable for evaluating the general practices’ service quality, andfinally do empirical research about this localized scale.Methods: By localization of the EUROPEP scale and repeated modification withDelphi method, the study developed the Chinese version of the scale that evaluatingpatients’ satisfaction on GPs. It randomly surveyed200patients that coming to thecommunity health service station and visiting their GPs in one urban district inTaiyuan and evaluated the reliability and validity of the scale. Test-retest reliability,internal consistency Cronbach’s α coefficient and Split-half reliability were used toevaluate the reliability; the construct validity and content validity were used toexamine the scale’s validity. Author investigated patients’ satisfaction on GPs andconducted a questionnaire survey with extended EUROPEP scale. All data wereanalyzed with SPSS19.0statistical software and many statistical methods were used,such as correlation analysis, principal component analysis, factorial analysis, t-testand variance analysis, as well as Kruskal-Wallis test when variances are not equal.Results:1. for test-retest reliability, the correlation coefficients of two EUROPEPscales between two weeks in the aspects of overall scales, patient-doctor-relationship,medical care, information and support, continuity and cooperation and accessibilitywere0.956,0.962,0.943,0.931,0.910,0.859(p<0.01), which were statisticallysignificant and showed that the extended EUROPEP scale’s test-retest reliability wasgood in terms of these five aspects and overall score.2. For internal consistency, thescale’s overall Cronbach’s α was0.983, which was greater than0.7and was close to 1, representing that the reliability of the extended EUROPEP scale was high. TheCronbach’s α in five dimensions were0.956,0.914,0.947,0.888,0.930and0.950.As these five values were all greater than0.9and also higher than the Cronbach’s αcoefficient of all items, further indicating that behavior characteristics described byitems and dimensions have the homogeny.3. The Split-half reliability of the scale inpart one and part two were0.815and0.898, P<0.001*. These two values were closeto1, showing that their indicators were highly correlated and the split-half reliabilityof the scale was good.4. After analyzed the five aspects of the scale and30itemswith Spearman method, it was found that each item was highly correlated with theaspect it belonged to and also had a low degree of correlation with other aspects,indicting that the scale has good convergent validity and discriminate validity, inother words, the scale has good content validity.5. Factorial analysis and principalcomponent analysis were used to evaluate the construct validity of the scale. Methodssuch as KMO test and Bartlett ball test were used to verify data. KMO value was0.938, indicating that the partial correlation is very weak and suitable for factorialanalysis. The statistic of the Bartlett’s test of sphericity prompted that refused theoriginal assumptions of correlation matrices and P＜0.01,which indicated that thedata are suitable for factor analysis. We can get5factors based on the characteristicvalue is greater than1, their rate of variance cumulative contribution is79.730%.After analyzing with factor rotation and based on the maximum factor loading thatoriginal variable corresponded to, the original variable was divided into5categoriesand perfectly matched with5factors of the scale, indicating that discriminate validityof the scale is high and this extended EUROPEP scale has a high construct validity.6.When investigated patients’ satisfaction on GPs, the top five items that patientsexpressed satisfactory and very satisfactory were: thoroughness, listening to you,knowing what he or she had done or told you during contacts, ensure that you haveenough time for diagnosis and treatment, telling you what you wanted to know aboutyour symptoms and/or illness, for which the response rate were89.1%,87.9%,87.8%,86.5%and86.5%. The next five items were: offering recover guidance for chronicand postoperative patients, good value for money, offering you services for preventing diseases, follow-up your state of illness, making you feel you had timeduring consultations, for which the response rate were79.7%,78.4%,78.3%,75.6%and75.6%.7. When analyzing the factors affecting patients’ satisfaction on GPs, itshowed that the elderly expressed a higher degree of satisfaction than middle-agedman and the young in all aspects. Except for two aspects of continuity andcooperation and medical care (P>0.05), age has no statistically effect on patients’satisfaction. Two groups including men and women were not statistically significant(P>0.05). The main effects of the education level on patients’ satisfaction indicatedthat the four groups of this factor were not statistically significant in all aspects(P>0.05).Conclusion: the extended EUROPEP scale which has a higher reliability and validitycan be used to evaluate patients’ satisfaction on GPs in community; explore thefactors that affect patients’ satisfaction toward service quality and put forwardsuggestions and policy advice for improvement.