Objective To develop an evaluation scale for the satisfaction with community-based home care for the elderly and examine its reliability and validity. Methods We developed the theoretical framework of Evaluation Scale for Satisfaction with Community-based Home Care for the Elderly (ESSCHCE) using SERVQUAL and theories about customer experience and formulated the initial ESSCHCE based on reviewing the related literature, expert consultation, and pilot study. From March to September, 2016, 738 elderly people from Tianjin were sampled for a questionnaire survey with the initial ESSCHCE by convenience sampling, and 2 weeks later, 30 of whom were randomly selected for re-examination. Item analysis of the scale was performed with critical ratio method, Pearson correlation coefficient. Exploratory factor analysis, confirmatory factor analysis, Cronbach's α, split-half reliability coefficient and test-retest reliability coefficient were used to evaluate the reliability and validity of the scale. Results The final scale consists of 8 dimensions (preventive care, consultation environment, management capabilities, doctor-patient trust, professional techniques, service attitude, diagnosis and treatment efficiency and equipment for diagnosis and treatment) and 34 items. Exploratory factor analysis revealed that the extracted 8 common factors explained 70.509% of the total variance. Confirmatory factor analysis showed that, the fitting degree of the model is good (χ2/df=1.481, GFI=0.894, AGFI=0.854, CFI=0.978, TLI=0.971, NFI=0.905, IFI=0.935, RMSEA=0.040). Cronbach's α:0.709-0.945 for subscales, and 0.973 for the total scale.Split-half reliability coefficient: 0.724-0.907 for subscales, and 0.902 for the total scale. Test-retest reliability coefficient: 0.799-0.888 for subscales, and 0.899 for the total scale. Conclusion The contents of the ESSCHCE meet the requirement of psychometrics with good discrimination, reliability and validity, which can be used as a tool for assessing the satisfaction with community-based home care for the elderly.%目的 构建专门用于测量我国社区居家养老医疗服务满意度的量表并进行信效度检验.方法 将SERVQUAL评价方法与顾客体验理论结合,构建我国社区居家养老医疗服务满意度量表的理论框架;通过文献研究、专家咨询及预调查等制定预试量表.于2016年3—9月,采用方便抽样法在天津市抽取738例老年人进行量表内容的问卷调查;2周后随机抽取其中的30例进行重测.根据两次调查的量表得分,采用临界比值法、相关性分析、探索性因子分析、验证性因子分析、Cronbach's α系数、分半信度及重测信度等进行量表条目筛选和信效度检验.结果 最终形成的量表包括预防保健、就诊环境、诊疗能力、医患信任、专业技能、服务态度、诊疗效率、诊疗设备8个维度,共34个条目.探索性因子分析结果显示,8个公因子的累计方差贡献率为70.509%;验证性因子分析结果显示,模型的整体拟合度较好[χ2/df=1.481、拟合优度指数(GFI)=0.894、调整拟合优度指数(AGFI)=0.854、相对拟合指数(CFI)=0.978、Tucker-Lewis指数(TLI)=0.971、标准化拟合指数(NFI)=0.905、增值拟合指数(IFI)=0.935、渐进残差均方和平方根(RMSEA)=0.040].总量表的Cronbach's α系数、分半信度、重测信度分别为0.973、0.902、0.899, 8个维度的Cronbach's α系数、分半信度、重测信度分别为0.709~0.945、0.724~0.907、0.799~0.888. 结论 编制的社区居家养老医疗服务满意度量表内容符合理论要求,区分度良好,具有较好的信度与效度,可以作为我国社区居家养老医疗服务满意度测量的适用工具.
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