Italian-language version of the Physical Therapy Outpatient Satisfaction Survey: cross-cultural adaptation and psychometric analysis

Background and Purpose. Patients’ satisfaction is a relevant outcome measure for health care providers. To date, no satisfaction questionnaire for outpatient physical therapy has been validated within Italian population. Methods The Italian version of the Physical Therapy Outpatient Satisfaction Survey (PTOPS-I) was obtained through forward-backward translation, final review, and pre-final version. Following the original proposal, the items were partitioned into four domains. The reliability of the questionnaire (and of the considered domains) was measured by internal consistency and test-retest stability at 7 days. Factor analysis was also used to verify the construct validity. The concurrent validity was measured by comparing the PTOPS-I scale with a 5-points Likert-type Scale assessing the Global Perceived Effect (GPE) of the treatment and with the Visual Analogue Scale (VAS). Results The development of a shared version of the PTOPS-I required three months, including the administration of the pre-final version to 50 subjects. 354 outpatients filled in the PTOPS-I, and 56 took the re-test after one week. Factor analysis confirmed the partition of the items into four blocks, identified as Enhancers (good experiences during the treatment), Detractors (perceptions regarding professional behaviors), Location, and Cost. The internal consistency (Cronbach’s alpha) was 0.758 for Enhancers, 0.847 for Detractors, 0.885 for Location, and 0.706 for Cost. The test-retest stability (Intra-class Correlation Coefficients) was 0.769 for Enhancers, 0.893 for Detractors, 0.862 for Location, and 0.862 for Cost. Concurrent validity (Pearson Correlation) with GPE was significant for all the domains but not for Location. Irrelevant or not significant correlations were observed with VAS. Discussion The PTOPS-I showed a good level of acceptability and required few minutes for the compilation. The satisfaction of the patients was mostly related to the relationship with his/her physical therapist (confidence, dialogue, respect of the privacy) as found from the correlation between global score and sub-totals, which indicated the most correlation with Detractors. The lowest level of satisfaction was found on the Cost domain. Conclusions The PTOPS-I showed good psychometric properties. Its use can be suggested for Italian-speaking population, for outpatients who receive physical therapy, both in public and in private facilities.