Development and Psychometric Validation of Perioperative Patient-Reported Experience Measures for Nursing Care in Surgical Patients

外科患者围手术期护理体验量表的开发和心理测量学验证

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Abstract

Background: Patient experience is a key indicator of healthcare quality. However, existing patient-reported experience measures (PREMs) predominantly focus on outpatient or general inpatient settings, with limited attention given to the perioperative period. Objective: This study aimed to develop and validate a perioperative PREMs tool tailored to assess nursing care in surgical patients. Methods: Adopting a mixed-methods approach guided by The International Association for Health Professions Education (AMEE) Guide No. 87, this study involved a literature review, semistructured interviews, expert consultations, cognitive interviews, pilot testing, and psychometric evaluation. Data were collected from 444 surgical patients at a tertiary hospital in China. Reliability (assessed through internal consistency and test-retest reliability) and validity (evaluated in terms of structural and content aspects) were assessed using Cronbach's α, intraclass correlation coefficient (ICC), confirmatory factor analysis (CFA), and factor analysis. Results: The final 18-item PREMs tool comprised three dimensions: Environmental and Nursing Care (eight items), Emotional Support and Communication (seven items), and Information Support (three items). The total scale demonstrated excellent internal consistency (Cronbach's α = 0.942), with subscale α values all exceeding 0.8. Test-retest reliability was strong (ICC > 0.7), and CFA results indicated a good model fit (comparative fit index = 0.928 and root mean square error of approximation = 0.046), confirming robust psychometric properties. Conclusion: The developed perioperative PREMs tool exhibited strong reliability and validity, offering a standardised means of evaluating surgical patients' experiences about nursing care and serving as a valuable resource for guiding targeted quality improvement initiatives.

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