Development of the Italian version of the Physical Therapy Patient Satisfaction Questionnaire. Cross-cultural adaptation, Reliability, and Validity

Background and Purpose. Patient’s satisfaction is an important measure for evaluating interventions in health care. No translated form of satisfaction questionnaire for physical therapy treatment has been validated to date in Italian population. Methods The Italian version of the Physical Therapy Patient Satisfaction Questionnaire (PTPSQ-I) was developed through forward-backward translation, final review, and pre-final version. The reliability was measured by internal consistency (Cronbach α) and test-retest repeatability at 7 days (Intra-class Coefficient Correlation). The concurrent validity was measured by comparing the PTPSQ-I with the Visual Analogue Scale (VAS) and with a 5-points Likert-type Scale evaluating the Global Perceived Effect (GPE) for the physical therapy treatment. Moreover, an acceptability analysis and a factor analysis were conducted. Results The process for obtaining a shared version of the PTPSQ-I required three months. 109 inpatients and 354 outpatients filled in the PPS-I and 108 took the re-test. The high number of ‘I do not know’ answers for some items suggested the opportunity to exclude them from the PTPSQ-I, leading to the definition of a reduced version, named PTPSQ-I(15). The PTPSQ-I(15) scale (sum of the scores on the 15 items) showed high internal consistency (α=0.9289) and good test-retest reliability (ICC=0.938). Concurrent validity was moderate for the GPE (r=0.33812, p<0.001), but not significant for the VAS (r=0.356, p=0.0188). The possible existence of more satisfaction dimensions was investigated using factor analysis, which evidenced the suitability of 2-factors structure (explaining together the 65% of the total variance). The estimated factors were interpreted as related to the perceived “competence” and “courtesy”. Discussion The Physical Therapy Patient Satisfaction Questionnaire, translated into Italian in its full version, did not have sufficient psychometric properties to be used to evaluate patient satisfaction with physical therapy in different Italian health care facilities. This situation suggested the opportunity to develop the PTPSQ-I(15) version, adapted to the Italian cultural and social context. The PTPSQ-I(15) version showed to be easily understood and self-administrable, requiring only few minutes to be completed. Conclusion The PTPSQ-I(15) showed satisfactory psychometric properties and its use can be recommended within Italian-speaking population, both for inpatient and for outpatient subjects.