Zun, Ahmad Badruridzwanullah
(2021)
The assessment of environment of care
in Hospital USM through in-patient
satisfaction survey and
ward rating audit.
Masters thesis, Universiti Sains Malaysia.
Abstract
The assessment of environment of care
in Hospital USM through in-patient
satisfaction survey and
ward rating audit
validity. The field testing process for HCAHPS Malay version was conducted among
200 discharged patients from Hospital USM. In part two, there were two surveys
conducted, first, in-patient satisfaction survey that involved 547 discharged patients in
determining the patient perception on EoC, patient satisfaction level and its associated
factor. Second, the ward rating audit survey as an objective assessment of physical
EoC was conducted concurrently with an in-patient satisfaction survey involving 13
wards.
Result: The overall content validation index (CVI) was calculated to be 0.87 and iCVI
for individual items ranged from 0.8 to 1.0. The face validity index (FVI) of clarity
and comprehension were 0.83 and 0.82, respectively, and the FVI universal was 0.82.
For construct validity, the factor loading ranging from 0.652 to 0.961 within nine
domains. The overall Cronbach alpha for the HCAHPS-Malay version was determined
to be 0.84 and values for each domain ranging from 0.69 to 0.93. About three fifth of
respondents were satisfied with hospital services. About 15.4% to 36.9% of the
patients have positive perception level in all EoC domains. The income level of the
patient and doctor–patient communication domain was significantly associated with
satisfaction level with (adj. OR = 0.38; 95% CI 0.17,0.88; P =0.023) and (adj. OR =
3.23; 95% CI: 2.01, 5.19; p < 0.001) respectively. The perception score for the physical
EoC comprised of cleanliness of the hospital environment was 3.11 (+ 0.94) while
quietness of the hospital environment was 2.52 (+1.24). For objective measure of
physical EoC, compliance of infection control had the highest mean score (4.42 + 0.40)
while physical cleanliness and patient safety domain shared the lowest mean score
with 3.92 + 0.51 and 3.92 + 0.83 respectively. There was a positive correlation between
the perception of cleanliness and an objective measure of a cleanliness of environment
(r=0.08, p value <0.05), safe environment (r= 0.14, p value <0.01), and conducive
environment (r = 0.11, p value <0.01).
Conclusion: This study provides an opportunity for improvement of EoC in Hospital
USM especially on the social EoC as the proportion of positive perception among
patient was considered low and the domain on communication with doctor was
associated with low satisfaction level. Besides that, the physical EoC also need to be
improved since it can be closely related with hospital infectious control and patient
safety.
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