Patient satisfaction, feasibility and reliability of satisfaction questionnaire among patients with pulmonary tuberculosis in urban Uganda: a cross-sectional study
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Date
2011
Journal Title
Journal ISSN
Volume Title
Publisher
Health Research Policy and Systems
Abstract
A comprehensive understanding of the barriers to and facilitators of poor tuberculosis (TB) treatment
outcome is still lacking; posing a major obstacle to finding effective solutions. Assessment of patient satisfaction in
TB programs would contribute to the understanding of gaps in healthcare delivery and the specific needs of
individual patients. However, tools for assessing patient satisfaction are lacking.
Objective: To establish patient satisfaction, the feasibility and reliability of a questionnaire for healthcare service
satisfaction and a questionnaire for satisfaction with information received about TB medicines among adult TB
patients attending public and private program clinics in Kampala, Uganda.
Methods: In a cross-sectional study, we recruited 133 patients of known HIV status and confirmed pulmonary TB
receiving care at the public and private hospitals in Kampala, Uganda. Participants were enrolled based on length
of TB treatment as follows: starting therapy, completed two months of therapy, and completed eight months of
therapy. A translated and standardized 13-item patient healthcare service satisfaction questionnaire (PS-13) and the
Satisfaction with Information about Medicines Scale (SIMS) tool were administered by trained interviewers. Factor
analysis was used to systematically group the PS-13 questionnaire into three factors of technical quality of care,
responsiveness to patient preference, and management of patient preference satisfaction subscales. The SIMS tool
was analyzed with two subscales of information about the action and usage of medication and the potential
problems with medication.
Results: Of the 133 participants, 35% (46/133) were starting, 33% (44/133) had completed two months, and 32%
(43/133) had completed eight months of TB therapy. The male to female and public to private hospital ratios in
the study population were 1:1. The PS-13 and the SIMS tools were highly acceptable and easily administered. Both
scales and the subscales demonstrated acceptable internal consistency with Cronbach’s alpha above 0.70. Patients
that were enrolled at the public hospital had relatively lower PS-13 satisfaction scores (0.48 (95% confidence
interval (CI), 0.42 - 0.52)), (0.86 (95% CI, 0.81 - 0.90)) for technical quality of care and responsiveness to patient
preferences, respectively compared to patients that were enrolled at the private hospital. For potential problems
SIMS subscale, male patients that were recruited at the public hospital had relatively lower satisfaction scores (0.58
(95% CI, 0.40 - 0.86)) compared to female patients after adjusting for other factors. Similarly, patients that had
completed eight months of TB treatment had relatively higher satisfaction scores (1.23 (95% CI, 1.06 - 1.44)) for
action and usage SIMS subscale, and higher satisfaction scores (1.09 (95% CI, 1.03 - 1.16)) for management of
patient preference (PS-13 satisfaction subscale) compared to patients that were starting treatment, respectively. A comprehensive understanding of the barriers to and facilitators of poor tuberculosis (TB) treatment
outcome is still lacking; posing a major obstacle to finding effective solutions. Assessment of patient satisfaction in
TB programs would contribute to the understanding of gaps in healthcare delivery and the specific needs of
individual patients. However, tools for assessing patient satisfaction are lacking.
Objective: To establish patient satisfaction, the feasibility and reliability of a questionnaire for healthcare service
satisfaction and a questionnaire for satisfaction with information received about TB medicines among adult TB
patients attending public and private program clinics in Kampala, Uganda.
Methods: In a cross-sectional study, we recruited 133 patients of known HIV status and confirmed pulmonary TB
receiving care at the public and private hospitals in Kampala, Uganda. Participants were enrolled based on length
of TB treatment as follows: starting therapy, completed two months of therapy, and completed eight months of
therapy. A translated and standardized 13-item patient healthcare service satisfaction questionnaire (PS-13) and the
Satisfaction with Information about Medicines Scale (SIMS) tool were administered by trained interviewers. Factor
analysis was used to systematically group the PS-13 questionnaire into three factors of technical quality of care,
responsiveness to patient preference, and management of patient preference satisfaction subscales. The SIMS tool
was analyzed with two subscales of information about the action and usage of medication and the potential
problems with medication.
Results: Of the 133 participants, 35% (46/133) were starting, 33% (44/133) had completed two months, and 32%
(43/133) had completed eight months of TB therapy. The male to female and public to private hospital ratios in
the study population were 1:1. The PS-13 and the SIMS tools were highly acceptable and easily administered. Both
scales and the subscales demonstrated acceptable internal consistency with Cronbach’s alpha above 0.70. Patients
that were enrolled at the public hospital had relatively lower PS-13 satisfaction scores (0.48 (95% confidence
interval (CI), 0.42 - 0.52)), (0.86 (95% CI, 0.81 - 0.90)) for technical quality of care and responsiveness to patient
preferences, respectively compared to patients that were enrolled at the private hospital. For potential problems
SIMS subscale, male patients that were recruited at the public hospital had relatively lower satisfaction scores (0.58
(95% CI, 0.40 - 0.86)) compared to female patients after adjusting for other factors. Similarly, patients that had
completed eight months of TB treatment had relatively higher satisfaction scores (1.23 (95% CI, 1.06 - 1.44)) for
action and usage SIMS subscale, and higher satisfaction scores (1.09 (95% CI, 1.03 - 1.16)) for management of
patient preference (PS-13 satisfaction subscale) compared to patients that were starting treatment, respectively.
Description
Keywords
Patient satisfaction, Feasibility, Questionnaire, Patients, Pulmonary tuberculosis
Citation
Babikako, H. M., Neuhauser, D., Katamba, A., & Mupere, E. (2011). Patient satisfaction, feasibility and reliability of satisfaction questionnaire among patients with pulmonary tuberculosis in urban Uganda: a cross-sectional study. Health Research Policy and Systems, 9(1), 1-13. doi:10.1186/1478-4505-9-6