Family Practice, Vol 15, 165-171, Copyright © 1998 by World Organization of Family Doctors
JG Howie, DJ Heaney, M Maxwell and JJ Walker
OBJECTIVES: We aimed to compare a new primary care outcome measure-the
Patient Enablement Instrument (PEI)-against two established satisfaction
measures [the Medical Interview Satisfaction Scale (MISS) and the
Consultation Satisfaction Questionnaire (CSQ)]. Specifically, we sought (i)
to test whether enablement and satisfaction are related or separate
concepts; and (ii) to assess whether the internal consistency of the PEI
might be enhanced by the inclusion of items from the satisfaction
instruments. METHODS: Questionnaire forms containing the three instruments
in a variety of combinations were distributed to a total of 818 patients
attending for routine surgery consultations in three urban general
practices of varying socio-economic mix. The main outcome measures were:
scores on the PEI; scores on the CSQ, the MISS and their individual
components; rank correlations between scores on the PEI and scores on the
CSQ, the MISS and their component subscales; and Cronbach's alpha
coefficient for the PEI. RESULTS: Overall mean scores, expressed as
percentages of maximum scores attainable, were 44.1% for the PEI, 76.9% for
the CSQ and 77.6% for the MISS. Rank correlations between PEI scores and
scores for the complete CSQ and MISS instruments were 0.48 (P < 0.01)
and 0.47 (P < 0.01), respectively. Correlations of PEI scores with
individual component scores on the CSQ were generally lower and ranged from
0.14 to 0.53; correlations of PEI scored with MISS component scores were
also generally lower and ranged from 0.21 to 0.53. Internal consistency of
the PEI items (assessed by Cronbach's alpha coefficient) was lowered when
items from the CSQ or MISS were added. CONCLUSIONS: The study shows that
'enablement' is a primary care outcome measure which is related to but is
different from general satisfaction.
ORIGINAL CLINICAL RESEARCH
A comparison of a Patient Enablement Instrument (PEI) against two established satisfaction scales as an outcome measure of primary care consultations
University of Edinburgh, Department of General Practice, UK.
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