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Patient and Family Satisfaction Following Emergency Obstetric Crisis: Validity and Reliability of a Novel Questionnaire
Abstract Number: F-46
Abstract Type: Original Research
Background: Despite consistent standard of care, obstetric emergencies carry high morbidity and mortality and often cannot be predicted or averted. There is growing recognition and consensus that the rapid-response system concept is readily transferrable to inpatient obstetric care with significant expected benefit for maternal/fetal morbidity. In June of 2005, Magee-Women’s Hospital of the University of Pittsburgh Medical Center was one of the first hospitals in the United States to implement such a system (Condition O) for emergent fetal and/or maternal conditions. Fetal and maternal emergencies that may trigger Condition O include postpartum hemorrhage, non-assuring fetal heart rate, abruption, shoulder dystocia, and emergency caesarian section. Increasingly, patient satisfaction questionnaires have been used as important indicators to support quality improvement in hospital settings. In our study, we wish to develop and assess the validity and reliability of the Patient and Family Satisfaction Questionnaire in obstetric crisis, as a proxy for quality of care and outcome measurement.
Methods: We modified a validated tool known as the Family Satisfaction in the Intensive Care Unit questionnaire (FS-ICU) in order to measure patient and family satisfaction following emergent obstetric crisis. A prospective study was performed examining 66 patients and 55 family members' completed questionnaires. Our version contains two different sections—the first segment, composed of 16 items, focuses on satisfaction with overall care and the second, composed of 10 items, assesses satisfaction with regard to medical decision-making. All questions employ Likert-5 response scales. During development, items were pretested for clarity and readability. The same scoring algorithm will be utilized to assess the modified version of the FS-ICU, given their similar constructs. Content and consensual validity were ensured by the manner of construction by an interdisciplinary panel including clinicians, MET responders, coordinators, as well as education specialists. Cronbach's alphas (α) were calculated to examine internal consistency reliability. The test-retest reliability of the instrument, as expressed by Pearson's r and intraclass correlation coefficient.
Results: Over 90 % of respondents had complete items for each of the sub- scales.The average overall satisfaction score was 94.2 ± 5.3. Internal consistency assessed by Cronbach’s alpha was consistently high across the two contructs: α=0.932 for the patient model and α=0.887 for the family model. The test and retest values were highly correlated for both models: (r = 0.78, p < 0.001) with intraclass coefficient of 0.89 for the family model.
Conclusion: The Patient and Family Satisfaction Questionnaire in Obstetric Crisis is psychometrically sound with regards to measurement of satisfaction with care and medical decision-making of patients and families.