Purpose. Patient-centered care has been identified as essential to redesigning the health care system (IOM, 2001). An agenda for transformation of the system has mandated that care delivery be responsive to patient preferences and expectations. Expectations are thought to form the basis for patient’s care-related evaluations. Understanding patient’s expectations for hospitalization is critical for patient-centered care. To date, little research has focused explicitly on expectations, despite their essential nature. The purpose of this project was to develop and test an instrument which measures patient expectations for hospital care. Methods. The instrument was developed in three phases. In the first phase, open-ended interviews were conducted with 20 patients to learn about their expectations or hopes for the current hospitalization. Interviews were analyzed using open coding; unique data bits were identified. Next, a new sample sorted the data bits using a 6-point scale. Medians were calculated for each item, with stable medians (small interquartile range) needed to retain an item. The third phase entailed design and testing. Findings. In the first phase, 105 unique data bits were identified. These were rated during phase two by an additional sample (n=18), resulting in 71 retained items. Final items represented these themes: safety/provider competence; provider attitudes/interpersonal behaviors; respectful, empathic treatment; hotel services; information; feelings of vulnerability and provider anticipation of needs; individualization; anticipation of discharge. The Patients Expectations Scale was administered to 240 patients at an academic medical center. Initial analysis reflects a stable factor structure (7 factors accounting for 57% of the variance) with excellent internal consistency (alpha > .82 all scales). The paper will address the factor analysis, reliability estimation and the correspondence of the factors with the qualitative themes. Relevance to Practice. Following additional testing, this instrument holds potential for use in evaluating care experiences based on a patient-centered approach.
Session #1198 - Decision Making
The 29th Annual MNRS Research Conference (April 1-4, 2005)