Development and testing of the Oncology Patients' Perceptions of the Quality of Nursing Care Scale.

PURPOSE/OBJECTIVES To develop and test the Oncology Patients' Perceptions of the Quality of Nursing Care Scale (OPPQNCS). STUDY DESIGN Development and psychometric testing of a scale to measure perceptions of patients with cancer of quality of nursing care. SETTING AND SAMPLE Hematology-oncology service of a comprehensive center in a New England tertiary medical center. The sample consisted of 436 patients in active treatment for cancer; two-thirds were female, and the mean age was 54.8 years. METHODS Eight subscales and 112 initial items were developed from concepts and data from a grounded theory study of patients' perspectives of the quality of their cancer nursing care. Fifty-nine items resulted from an expert panel's review for content validity. Construct validity was tested using exploratory factor analysis. Principal components analyses (PCA) with promax (oblique) rotation were conducted. Criteria for item retention were a factor loading of greater than or equal to 0.4 and unambiguous loading on one factor. Internal consistency reliability was determined using coefficient alpha. FINDINGS The initial PCA yielded four factors that explained 81% of the variance. Three forced four-factor solutions using PCA and promax rotation were required for all items to meet criteria. The final scale included 40 items (alpha = 0.99) in four subscales: responsiveness (22 items, alpha = 0.99), individualization (10, 0.97), coordination (3, 0.87), and proficiency (5, 0.95). A short form (18 items, alpha = 0.97) was created using stepwise regression. CONCLUSIONS Psychometric properties indicated that both OPPQNCS forms adequately measure cancer nursing care quality from the patient's perspective. IMPLICATIONS FOR NURSING The OPPQNCS holds promise for nurses who wish to monitor and improve the quality of patient-centered cancer nursing care and those who wish to investigate relations among care quality and healthcare system characteristics, patient characteristics, and nurse sensitive patient outcomes.