Background and study aims: Patient satisfaction is a key indicator of the quality of gastrointestinal (GI) endoscopy. The aim of this study was to develop and validate a specific patient satisfaction questionnaire for patients undergoing GI endoscopy – the Gastrointestinal Endoscopy Satisfaction Questionnaire (GESQ).
Patients and methods: We developed and validated the GESQ within the context of a national multi-institution nurse endoscopy trial, based in secondary care, in three stages: (1) item generation with a panel of patients and professionals following a detailed literature review to identify the most relevant items from existing scales; (2) development and piloting of a draft questionnaire on a sample of patients referred for GI endoscopy; and (3) testing of the questionnaire within a large multicenter pragmatic randomized trial. We undertook psychometric analysis of the questionnaire to identify the underlying dimensions and assessed the questionnaire for reliability and validity.
Results: The final version of the GESQ contains 21 items. Principal components analysis revealed four subscales with high internal consistency: skills and hospital (seven items; Cronbach’s alpha 0.83), pain and discomfort during and after endoscopy (four items; Cronbach’s alpha 0.84), information before endoscopy (five items; Cronbach’s alpha 0.80), and information after endoscopy (five items; Cronbach’s alpha 0.76).
Conclusions: The four identified subscales are clinically relevant and correspond to domains of patient satisfaction identified in previous studies. Our development and validation of the GESQ confirmed that it is a valid, reliable, interpretable, and acceptable tool to measure satisfaction in patients who have undergone a GI endoscopy.
2 Asadi-Lari M, Tamburini M, Gray D. Patients’ needs, satisfaction, and health related quality of life: towards a comprehensive model. Health Qual Life Outcomes 2004; 2: 32
3 Ladas SD, Novis B, Triantafyllou K et al. Ethical issues in endoscopy: patient satisfaction, safety in elderly patients, palliation, and relations with industry. Second European Symposium on Ethics in Gastroenterology and Digestive Endoscopy; July 2006; Kos, Greece. Endoscopy 2007; 39: 556-565
4 Casellas F, Ginard D, Vera I et al. Development and testing of a new instrument to measure patient satisfaction with health care in inflammatory bowel disease: the CACHE questionnaire. Inflamm Bowel Dis 2013; 19: 559-568
11 Dougall A, Russell A, Rubin G et al. Rethinking patient satisfaction: patient experiences of an open access flexible sigmoidoscopy service. Soc Sci Med 2000; 50: 53-62
13 Williams J, Russell I, Durai D et al. What are the clinical outcome and cost-effectiveness of endoscopy undertaken by nurses when compared with doctors? A Multi-Institution Nurse Endoscopy Trial (MINuET). Health Technol Assess 2006; 10: 1-195 iii–iv, ix-x
14 Williams J, Russell I, Durai D et al. Effectiveness of nurse delivered endoscopy: findings from randomised multi-institution nurse endoscopy trial (MINuET). BMJ 2009; 338: b231
24 Hagerty MR, Land KC. Constructing summary indices of quality of life. a model for the effect of heterogeneous importance weights. In: Vogt WP, ed Quantitative Research Methods. London: Sage Publications Ltd; 2001
27 Williams JG, Cheung WY, Cohen D et al. Evaluating innovations in the delivery and organisation of gastroenterology services initiated directly or indirectly by the Modernising Endoscopy Services programme of the NHS Modernisation Agency: (ENIGMA). Southamptom: National Institute for Health Research Service Delivery and Organisation. 2008
28 Bini E, Firoozi B, Choung R et al. Systematic evaluation of complications related to endoscopy in a training setting: A prospective 30-day outcomes study. Gastrointest Endosc 2003; 57: 8-16
29 Smith JK, Falvo D, McKillip J et al. Measuring patient perceptions of the patient-doctor interaction. Development of the PDIS. . Eval Health Prof 1984; 7: 77-94
