PSNCQQ Scale Information


A 5-point Likert scale ranging from poor to excellent is used for each item of the PSNCQQ. There are 2 methods to score the PSNCQQ. For general results, the scores for all items can be summed and averaged to yield a single value for each patient. For detailed feedback and more "actionable" results, item means and standard deviations can be calculated. Another option is to compute the percentage of "strongly agree" responses for each item. These results can be used to track changes over time or to evaluate the effects of quality improvement initiatives. The results can also be used for comparisons between units and hospitals.


The Cronbach α reliability estimates for the PSNCQQ are excellent (.97). Item total correlations are high, ranging from 0.61 to 0.89. Reliability estimates are similar across different hospital categories (teaching, community, small). This suggests that patients in different types of hospital systems are interpreting the items on the PSNCQQ in a consistent manner.


Construct validity has been established through exploratory factor analysis and confirmatory factor analyses. The results of the EFA revealed a 1-factor solution with factor loadings greater than 0.70 (range was 0.753 to 0.890). A confirmatory factor analysis confirmed the 1- factor model. Various fit indices demonstrated a good fit of this model to the data (χ2 = 14.36, GFI = 0.944, IFI = 0.958, CFI = 0.958, RMSEA = 0.091). The predictive validity of the PSNCQQ has been examined by testing its ability to predict expected outcomes frequently used for validation purposes in health services research. After adjusting for length of stay, gender, age, and self-rated health, the PSNCQQ explained significant amounts of the variance in the overall quality of care and services (64%), overall quality of nursing care (73%), and intent to recommend the hospital to family and friends, in the combined sample of hospitals (55%). To measure the sensitivity of the PSNCQQ, the overall satisfaction with care measure was dichotomized into 2 groups: excellent/very good and poor/fair responses. The excellent/ very good group had significantly higher scores on the PSNCQQ than had the poor/fair group (M = 3.18, SD = 0.59, and M = 1.17, SD = 0.71, for the high and low groups, respectively). The PSNCQQ has been demonstrated to discriminate between high and low levels of overall patient satisfaction with the care they received during their hospital stay and added further support for the construct validity of the instrument.


1Meterko M, Nelson EC, Rubin HR, et al. (1990). Patients’ judgment of hospital quality: A report on a pilot study. Medical Care, 28 (suppl.), S1–S56.
2Laschinger, H.K.S., McGillis Hall, L., Pedersen, C., & Almost, J. (2005). A Psychometric Analysis of the Patient Satisfaction With Nursing Care Quality Questionnaire An Actionable Approach to Measuring
Patient Satisfaction. Journal of Nursing Care Quality, 20 (3), 220-230.