The 'Medical Interview Satisfaction Scale' (MISS-21) adapted for British general practice
The 'Medical Interview Satisfaction Scale' (MISS-21) adapted for British general practice
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DOI：
10.1093/fampra/19.3.257
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发表时间：
2002-06-01
期刊：
影响因子：
2.2
通讯作者：
Weinman, J
中科院分区：
文献类型：
--
作者：
Meakin, R;Weinman, J
背景29项“医疗访谈满意度量表”（MISS-29）是在美国开发的，用于评估患者对个体医生-患者咨询的满意度。它已被用于研究从英国的一般做法。然而，在这一人群中，其心理测量学特性的证据有限。本研究的目的是检查的有效性，可靠性和适用性的MISS-29在英国的全科医学人口。研究分为两个阶段。第一项研究调查了MISS-29在英国全科人群中的特性，并产生了改良的MISS（MISS-21）。第二项研究调查了MISS-21在更广泛的英国全科人群中的特性。在第一阶段，150名16岁以上的患者从参加伦敦北部郊区一个大型团体实践的患者中依次招募。患者完成了一份问卷，收集人口统计学数据和MISS-29。在第二阶段，从16岁以上的患者中招募了159名患有新问题的患者，这些患者咨询了北伦敦、埃塞克斯和萨福克郡的18名全科医生。患者在等待看医生时完成了一份调查问卷;这份调查问卷收集了人口统计学数据，包括作者设计的六个单独的项目，旨在衡量患者对以前与医生协商的满意度。患者在离开诊室时完成MISS-21。I期和II期研究的缓解率分别为76.9%和72.6%。因子分析，使用主成分分析与方差最大旋转，在第1阶段收集的数据，导致在一个21个项目的规模与原来的MISS-29相同的四个分量表。各分量表之间的相关性在0.46至0.65之间。Cronbach的α值在0.67和0.92之间，表明在研究条件下，分量表是内部一致的。在第2阶段，92.1%的患者完成了MISS-21中的所有项目，患者的人口统计学变量与完成的MISS-21问卷的比例之间没有显著关系，不同类型的实践或服务于不同地理人群的实践之间完成的MISS-21问卷的比例也没有任何差异，这表明这些项目是患者可以接受的。MISS-21量表得分与既往就诊满意度各方面均呈显著正相关（0.21-0.63），为MISS-21量表的结构效度提供了支持。这项研究表明，在英国的一般实践中使用的29项MISS在美国开发的应谨慎对待。然而，一个新的21个项目的版本，具有相同的四个分量表的29个项目的MISS开发具有令人满意的内部信度。分量表之间的相关性表明，它们代表相当离散，但重叠的满意度方面。证据表明，患者完成MISS-21的困难较小，并且它适用于评估英国不同实践类型和人群的咨询满意度。有限的数据支持MISS-21的结构效度。虽然这项研究并没有提供一个完整的评估MISS-21，我们相信它提供了证据，其心理测量特性，这表明它是一个有效的和可靠的工具，用于评估患者的满意度与个人咨询在英国的一般做法。
Background. The 29-item 'Medical Interview Satisfaction Scale' (MISS-29) was developed in the USA to assess patient satisfaction with individual doctor-patient consultations. It has been used in studies from British general practice. However, there is limited evidence for its psychometric properties in this population.Objectives. The present study was designed to examine the validity, reliability and applicability of the MISS-29 in British general practice populations.Methods. The study was divided into two phases. The first investigated the properties of the MISS-29 in a UK general practice population and resulted in a modified MISS (MISS-21). The second investigated the properties of the MISS-21 in a wider UK general practice population. In phase 1, 150 patients over 16 years were recruited sequentially from patients attending a large group practice in suburban north London. Patients completed a questionnaire which collected demographic data and the MISS-29. In phase 2, 159 patients with a new problem were recruited from patients over 16 years consulting 18 GPs in north London, Essex and Suffolk. Patients completed a questionnaire while waiting to see the doctor; this collected demographic data and included six separate items, designed by the author, intended to measure patient satisfaction with previous consultations with the doctor. The patients completed the MISS-21 when they left the doctor's consulting room.Results. The response rates for the phase 1 and phase 2 studies were 76.9 and 72.6%, respectively. Factor analysis, using principal component analysis with a varimax rotation, of the data collected in phase 1 resulted in a 21-item scale with the same four subscales as the original MISS-29. Correlations between subscales range from 0.46 to 0.65. Values of Cronbach's alpha between 0.67 and 0.92 suggest that the subscales are internally consistent under the conditions of the study. In phase 2, 92.1% completed all the items in the MISS-21 and there were no significant relationships between patients' demographic variables and the proportion of completed MISS-21 questionnaires, nor were there any differences in the proportion of completed MISS-21 questionnaires between type of practice or between practices serving different geographic populations, suggesting that the items were acceptable to patients. There were highly significant positive correlations (0.21-0.63) between scores on the MISS-21 and all aspects of satisfaction with previous consultations, providing supportive evidence for the construct validity of the MISS-21.Conclusion. This study has demonstrated that the use in British general practice of the 29-item MISS developed in the USA should be treated with caution. However, a new 21-item version with the same four subscales as the 29-item MISS was developed which has satisfactory internal reliability. The correlations between subscales suggest that they represent fairly discrete but overlapping aspects of satisfaction. Evidence is produced suggesting that patients have less difficulty completing the MISS-21 and that it is applicable for assessing satisfaction with the consultation in different practice types and populations in the UK. Limited data supporting the construct validity of the MISS-21 are presented. While this study does not provide a full assessment of the MISS-21, we believe it provides evidence for its psychometric properties, which suggests that it is a valid and reliable instrument for the assessment of patient satisfaction with individual consultations in British general practice.