Measurement of Patients' Perceptions of the Quality of Acute Stroke Services: Development and Validation of the STROKE Perception Report

作者：Anne W. Alexandrov, Barbara B. Brewer, Kari Moore, Charlene Grau, Dana J. Beenstock, Fern Cudlip, Deborah Murphy, Lynn Klassman, Andrea Korsnack, Brenda Johnson, Connie F. Parliament, Patricia Lane, Tina Walsh, Deidra Gottbrath, Alexis J Wojner, Stephen E. DiBiase, Andrei V. Alexandrov · 发表于：Journal of Neuroscience Nursing · 年份：2019 · DOI：10.1097/jnn.0000000000000471 · 被引用次数：13 · 研究领域：Acute Ischemic Stroke Management、Stroke Rehabilitation and Recovery、Health Education and Validation

INTRODUCTION: Patients' perceptions of healthcare quality have become an important part of quality measurement. We explored patients' and family's lived experiences during acute stroke hospitalization to develop a quantitative instrument. METHODS: Focus groups were conducted using open-ended scripted questions. Interview data were coded and analyzed using an inductive approach to thematic analysis. Symmetric patient and family instruments were developed based on qualitative domains and serially refined to a set of 30 survey items, 12 stroke knowledge test items, and 5 subject demographic fields. Scales were evaluated for internal consistency reliability using Cronbach α; construct validity with exploratory factor analysis using principal components with varimax rotation was performed to determine the extent to which items in a scale measure the same underlying factor. Feasibility of an electronic cloud-based survey was also tested. RESULTS: Three main themes emerged: fast action to diagnose and treat stroke, genuine caring, and education to prevent and respond to stroke. A total of 1029 subjects completed the final instrument with no differences in perception found by race, ethnicity, or length of stay. Scales showed satisfactory internal consistency reliability (Cronbach α scores, .89-.94); factor loadings across each scale ranged from 0.55 to 0.87. Data entry by electronic pad was perceived by 77% to be more confidential than paper surveys; median score for difficulty was 4...