Endoscopy 2015; 47(12): 1137-1143
DOI: 10.1055/s-0034-1392547
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Development and validation of the Gastrointestinal Endoscopy Satisfaction Questionnaire (GESQ)

Hayley A. Hutchings
1   College of Medicine, Swansea University, Swansea, UK
,
Wai-Yee Cheung
1   College of Medicine, Swansea University, Swansea, UK
,
Laith Alrubaiy
1   College of Medicine, Swansea University, Swansea, UK
,
Dharmaraj Durai
2   Department of Gastroenterology, University Hospital of Wales, Cardiff, UK
,
Ian T. Russell
1   College of Medicine, Swansea University, Swansea, UK
,
John G. Williams
1   College of Medicine, Swansea University, Swansea, UK
› Author Affiliations
Further Information

Publication History

submitted 29 January 2015

accepted after revision 14 May 2015

Publication Date:
08 September 2015 (online)

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.

Appendix e1 and e2

 
  • References

  • 1 Pascoe GC. Patient satisfaction in primary health care: a literature review and analysis. Eval Program Plann 1983; 6: 185-210
  • 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
  • 5 Cohen J, Pike IM. Defining and Measuring Quality in Endoscopy. Am J Gastroenterol 2015; 110: 46-47
  • 6 Faigel DO, Pike IM, Baron TH et al. Quality indicators for gastrointestinal endoscopic procedures: an introduction. Gastrointest Endosc 2006; 63: S3-S9
  • 7 Global Rating Scale. Available from: http: //www.globalratingscale.com/ Accessed: 19 December 2014
  • 8 Armstrong D, Hollingworth R. Endoscopy and quality assurance – It is here!. Can J Gastroenterol 2007; 21: 255-256
  • 9 Yacavone RF, Locke 3rd GR, Gostout CJ et al. Factors influencing patient satisfaction with GI endoscopy. Gastrointest Endosc 2001; 53: 703-710
  • 10 Sitzia J. How valid and reliable are patient satisfaction data? An analysis of 195 studies. . Int J Qual Health Care 1999; 11: 319-328
  • 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
  • 12 Johanson JF, Schmitt CM, Deas TM et al. Quality and outcomes assessment in Gastrointestinal Endoscopy. Gastrointest Endosc 2000; 52: 827-830
  • 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
  • 15 Richardson G, Bloor K, Williams J et al. Cost effectiveness of nurse delivered endoscopy: findings from randomised multi-institution nurse endoscopy trial (MINuET). BMJ 2009; 338: b270
  • 16 Streiner GL, Norman RD. Health measurement scales. A practical guide to their development and use. 4th edn. Oxford: Oxford University Press; 2008
  • 17 Cotton PB, Williams CB. Diagnostic upper endoscopy. Practical gastrointestinal endoscopy. 4th edn. Cambridge, Massachusetts: Blackwell Science; 1996
  • 18 Baillie J. Gastrointestinal endoscopy: basic principles and practice. Oxford: Butterworth Heinemann; 1992
  • 19 Sivak MVJ. Technique of upper gastrointestinal endoscopy. In: Lamsback W, ed. Gastroenterologic Endoscopy. Philadelphia: Saunders; 1987: 272-295
  • 20 Field A. Discovering statistics using IBM SPSS statistics. 4th edn. London: Sage Publications Ltd; 2013
  • 21 Joliffe IT. Principal components analysis. 2nd edn. New York: Pringer-Verlag; 2002
  • 22 Stevens JP. Applied multivariate statistics for the social sciences. 4th edn. Hillsdale, New Jersey: Erlbaum; 2002
  • 23 Nunnally JC, Bernstein IR. Psychometric Theory. 3rd edn. New York: McGraw-Hill; 1994
  • 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
  • 25 Hagerty MR, Cummins RA, Ferriss AL et al. Quality-of-life indexes for national policy: review and agenda for research. Soc Indic Res 2001; 55: 1-96
  • 26 Schoenfeld P, Piorkowski M, Allaire J et al. Flexible sigmoidoscopy by nurses: state of the art 1999. Gastroenterol Nurs 1999; 22: 254-261
  • 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