PDF 
Views 
Share
Measuring Satisfaction in Breast Cancer Patients Receiving Ambulatory Care: A Validation Study
CC BY 4.0 · Indian J Med Paediatr Oncol 2022; 43(06): 473-479
DOI: DOI: 10.1055/s-0041-1735601
Abstract
Introduction Patient satisfaction constitutes a vital service quality indicator. It provides a measure of the gap in health-care requirements and patients' expectations.
Objective The aim of this study was to perform linguistic validation of the questionnaire assessing satisfaction with outpatient care.
Materials and Methods A tool for measuring patient satisfaction was developed and validated at our institute in the English language. This tool was translated into Hindi and Marathi. Subsequently, 339 patients diagnosed with breast cancer consulting in the outpatient department from the different parts of India and having diverse linguistic and socioeconomic backgrounds were enrolled. Patients were asked to complete the satisfaction tool after consultation at a single point of time in a prospective manner.
Results All patients completed the questionnaire. The questionnaire was filled by 120, 116, and 103 patients in Hindi, Marathi, and English, respectively. Both convergent validity and discriminant validity were supported as the correlation coefficient was >0.4 for all items within a scale and <0>0.9 for all the questions. The mean overall satisfaction score was 88.35 (standard deviation: 19.63). Patients were satisfied in all the aspects of the consultation process, including appointment scheduling, assistant medical staff and faculty, and treating physician. However, some expressed dissatisfaction toward long-waiting times.
Conclusion The translated tool is reliable and valid and effectively measures the satisfaction of patients receiving ambulatory care.
Ethics
This study was approved by the Tata Memorial Centre Ethics Committee on March 22, 2017 and project number 1835 was assigned. Patients were given consent forms in their preferred language and written consent was obtained. The procedures followed were in accordance with the ethical standards of the institutional committee on human experimentation and with the Helsinki Declaration of 1964, as revised in 2013.
Publication History
Received: 23 May 2020
Accepted: 06 August 2020
Article published online:
29 November 2021
© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
Abstract
Introduction Patient satisfaction constitutes a vital service quality indicator. It provides a measure of the gap in health-care requirements and patients' expectations.
Objective The aim of this study was to perform linguistic validation of the questionnaire assessing satisfaction with outpatient care.
Materials and Methods A tool for measuring patient satisfaction was developed and validated at our institute in the English language. This tool was translated into Hindi and Marathi. Subsequently, 339 patients diagnosed with breast cancer consulting in the outpatient department from the different parts of India and having diverse linguistic and socioeconomic backgrounds were enrolled. Patients were asked to complete the satisfaction tool after consultation at a single point of time in a prospective manner.
Results All patients completed the questionnaire. The questionnaire was filled by 120, 116, and 103 patients in Hindi, Marathi, and English, respectively. Both convergent validity and discriminant validity were supported as the correlation coefficient was >0.4 for all items within a scale and <0>0.9 for all the questions. The mean overall satisfaction score was 88.35 (standard deviation: 19.63). Patients were satisfied in all the aspects of the consultation process, including appointment scheduling, assistant medical staff and faculty, and treating physician. However, some expressed dissatisfaction toward long-waiting times.
Conclusion The translated tool is reliable and valid and effectively measures the satisfaction of patients receiving ambulatory care.
Keywords
breast cancer - outpatient - patient satisfaction - satisfaction survey
Introduction
Nowadays, a lot of attention is paid toward the patient's perception of the services provided, especially in oncology. Patient satisfaction measures the gap in the quality of service delivered and patients' expectations.[1] There are various definitions of patient satisfaction.[1] [2] [3] [4] [5] [6] [7] [8] [9] [10] [11] [12] It measures the patient's contentment with health-care services.[13] Heath states that a truly satisfied patient can be recognized if he leaves the physician's clinic with a happy feeling.[14] Assessment of satisfaction levels provides a patient-centered dimension of assessing health systems.[15] It is important to assess patient satisfaction with the services at multiple levels as medical care is provided by a team of physicians, nurse, and other ancillary staff. It also forms a vital measure of quality tracking and is usually employed by the hospital administrators as a performance indicator.[16]
While there are numerous methods of evaluating patient satisfaction, satisfaction surveys are widely employed because they are easier to perform. There are numerous validated surveys available to measure patient satisfaction like the European Organization for Research and Treatment of Cancer inpatient and outpatient satisfaction questionnaire (EORTC QLQ-OUTPATSAT35, INPATSAT 32),[17] [18] Patient Satisfaction and Quality in Oncological Care,[19] Long form Patient Satisfaction Questionnaire (PSQ-III),[20] and Princess Margaret Hospital Satisfaction with Doctor Questionnaire (PMH-PSQ-MD)[21] are a few of them. They are developed to test the satisfaction of inpatients and also have restricted questions for differential evaluation of various members of the medical team (resident, physician, or nurse). As the needs of developing nations are far different from a developed nation,[22] [23] these above questionnaires need to be validated in the Indian setting. Unfortunately, none of these tools were found to be validated in the Indian population till the time of reporting of this study. Hence, we decided to develop an indigenous questionnaire that will be suitable for the Indian population and can be used in an outpatient department (OPD). It was developed in the English language in phase I and pilot tested in 50 patients who were fluent in English and attending the outpatient breast clinic at our institute.[24] This tool was subsequently translated in local languages, that is, Hindi and Marathi. In this study, we intend to perform linguistic validation of the tool in patients with varied linguistic and socioeconomic background as well as test the validity and reliability of this translated questionnaire in a larger cohort of patients.
Materials and Methods
The development process and the initial pilot testing of the patient satisfaction survey (PSS) questionnaire have been published earlier.[24] The results of pilot testing supported convergent validity showing high internal consistency and high reliability. The PSS tool consisted of 28 questions; six questions related to administrative services; one question on waiting time; eight questions on ancillary members of the medical team comprising of resident doctors, nurses, and other staff; and ten questions about the treating consultant. The participants could choose any one of the options on a numerical scale of 1 (very dissatisfied) to 5 (very satisfied) depending upon their experience after OPD consultations. The last three questions were open-ended, and the responses were to be scored as Yes or No. The respondents at the end had to rate their overall satisfaction on the same scale ranging from 1 to 5. Our previous publication describes the details of scoring and conversion of raw scores to final scores that were used for the analysis. The initial tool was developed only in the English language; further, the tool was translated into Hindi and Marathi language each by two independent translators. The draft Hindi and Marathi tools were back-translated by two different independent translators, and a final tool was generated. These final versions of Hindi and Marathi tools along with the English tool were served to the patients as per their preferred language at their first consultation in a prospective manner. Patients from all over India with different socioeconomic backgrounds who were diagnosed with breast cancer and attending outpatient clinics for consultation in our hospital were screened and consequently enrolled. Patients with metastatic disease and poor performance status were excluded from the study.
Patients who had histologically confirmed the diagnosis of breast cancer, planned to receive multimodality cancer-directed therapy (surgery, chemotherapy, and radiation therapy) and who were able to understand either of the three languages were screened for the study and consented. Unfit patients with poor performance status and those unable to read and comprehend the questionnaire were excluded.
To reduce bias, the translated tool was served after the patient had OPD consultation by a clinical research staff not involved in patient care. Patients were asked to fill the tool waiting in the clinic area, and it was anonymous. Three hundred and thirty-nine patients diagnosed with breast cancer consulting in an outpatient clinic in our hospital were enrolled.
Statistical Analysis
The analysis was done using the Statistical Package for the Social Sciences software version 23.0. A pilot study conducted in Tata Memorial Hospital with the PSS questionnaire has shown that ∼70% of the patients are satisfied with the health-care services. Assuming that the proportion of patients satisfied with the health services, when assessed by Hindi and Marathi PSS questionnaire, would be ± 5% of 70% (between 65% to 75%), a sample size of 340 would be needed to produce a two-sided 95% confidence interval (CI), which was determined by using CIs Formula-Clopper-Pearson method. Data were summarized using the standard measures of central tendency based on the normality distribution of the variables. The item scale and scale–scale correlations were studied for measuring the discriminant and convergent validity. Convergent validity was performed by using the Spearman rank correlation. If individual items within a scale showed moderate or high correlation within their scale (>0.40) convergent validity would be proven. For discriminant validity, to indicate that the two scales are different in construct, scale to scale correlation coefficient of ≤0.70 was required. Discriminant validity for each item was tested by counting the number of times that the item correlated higher with items of other domains than with items of its own domain. Campbell and Fiske suggest that the count should be <1 href="https://www.thieme-connect.com/products/ejournals/html/10.1055/s-0041-1735601#JR23620-25" xss=removed>25] The Kaiser-Meyer-Olkin (KMO),[26] a measure of sampling adequacy and Bartlett's test of Sphericity,[27] which are standard tools for exploratory factor analysis, were used for inferring construct validity. A value of KMO ≥0.5 and p ≤ 0.05 for Bartlett's test is supposed to support construct validity. Similarly, internal consistency and reliability of the questionnaire were assessed by Cronbach's α coefficient. A value of Cronbach's α coefficient ≥0.70 supports internal consistency.
Results
All 339 female patients who gave consent for the study responded to the entire questionnaire that showed a high compliance of 100%. The demographic details of the study cohort are shown in [Table 1]. The paid and subsidized categories were equally distributed. Majority of the patients were literate 314 (94.6%), homemakers 261 (77.0%), and had good family support 310 (91.4%). Local patients comprised 20% of the entire cohort. The questionnaire was filled in Hindi, Marathi, and English by 120, 116, and 103 patients, respectively.
|
Characteristics |
Numbers (percentages) |
|---|---|
|
Age |
Median 49 years (range: 25–80 years) |
|
Stage (%) |
Stage I—38 (11.2) |
|
Stage II—88 (26.1) |
|
|
Stage III—213 (62.7) |
|
|
Laterality (%) |
Left—180 (53.0) |
|
Right—156 (46.1) |
|
|
Bilateral—3 (0.9) |
|
|
Category (%) |
Fully paid—172 (50.7) |
|
Subsidized—167 (49.3) |
|
|
Family/social support (%) |
Yes—310 (91.4) |
|
No—29 (8.6) |
|
|
Education level (%) |
Nil—12 (3.5) |
|
Primary—66 (19.5) |
|
|
Secondary—92 (27.1) |
|
|
Graduate—151 (44.5) |
|
|
Postgraduate—5 (1.5) |
|
|
Not mentioned—13 (3.8) |
|
|
Occupation (%) |
Homemaker—261 (77) |
|
Student—1 (0.3) |
|
|
Employed—61 (18) |
|
|
Retired—7 (2.1) |
|
|
Not mentioned—3 (0.9) |
|
|
Place of residence (%) |
Mumbai—81 (20.3) |
|
Outside Mumbai—258 (79.7) |
|
Questions |
Cronbach's α |
Interitem correlation |
Interitem correlation significance value |
Scale–scale discriminant validity |
|---|---|---|---|---|
|
Items (1–6) appointment and secretarial assistance |
0.93 |
0.62–0.78 |
<0> |
0.41–0.65 |
|
Items (9–16) assisting medical staff and facilities |
0.96 |
0.70–0.85 |
<0> |
0.42–0.70 |
|
Items (17–26) treating physician (consultant) |
0.97 |
0.67–0.86 |
<0> |
0.40–0.70 |
|
Scales |
Bartlett's sphericity |
KMO |
Factor loading |
Variance explained (%) |
|---|---|---|---|---|
|
Items related to your appointment and secretarial assistance |
||||
|
Ease of scheduling your appointment |
<0> |
0.902 |
0.702 |
74.84 |
|
Courtesy |
0.761 |
|||
|
Efficiency |
0.758 |
|||
|
Communication skill |
0.779 |
|||
|
Availability of the physician |
0.702 |
|||
|
Overall satisfaction |
0.788 |
|||
|
Items related to the assisting medical staff and facilities |
||||
|
Thoroughness about case |
<0> |
0.943 |
0.765 |
79.20 |
|
Courtesy |
0.847 |
|||
|
Efficiency |
0.815 |
|||
|
Communication skill |
0.784 |
|||
|
Clarity in explanation |
0.765 |
|||
|
Ability to resolve your queries |
0.797 |
|||
|
Privacy of consultation |
0.742 |
|||
|
Overall satisfaction |
0.821 |
|||
|
Items related to your treating physician (consultant) |
||||
|
Time spent |
<0> |
0.945 |
0.713 |
80.01 |
|
Willingness to listen |
0.821 |
|||
|
Ability to explain |
0.823 |
|||
|
Explanation of tests |
0.805 |
|||
|
Your involvement |
0.741 |
|||
|
Ability to diagnose problems |
0.818 |
|||
|
Skill in treating condition |
0.798 |
|||
|
Responsiveness to questions |
0.817 |
|||
|
Gave comfort and support |
0.822 |
|||
|
Overall satisfaction |
0.857 |
|
Items related to your treating physician |
Mean (SD) patients satisfaction score |
|---|---|
|
Time spent |
85.77 (22.47) |
|
Willingness to listen |
88.20 (21.86) |
|
Ability to explain |
88.72 (22.09) |
|
Explanation of tests |
88.86 (20.97) |
|
Your involvement |
88.13 (21.26) |
|
Ability to diagnose problems |
90.78 (19.56) |
|
Skill in treating a condition |
90.86 (19.07) |
|
Responsiveness to questions |
88.72 (20.71) |
|
Gave comfort and support |
89.68 (20.18) |
|
Overall satisfaction |
90.19 (19.37) |
|
Overall satisfaction |
88.35 (19.63) |
References
- Pascoe GC. Patient satisfaction in primary health care: a literature review and analysis. Eval Program Plann 1983; 6 (3-4): 185-210
- Xesfingi S, Vozikis A. Patient satisfaction with the healthcare system: Assessing the impact of socio-economic and healthcare provision factors. BMC Health Serv Res 2016; 16: 94
- Sitzia J, Wood N. Patient satisfaction: a review of issues and concepts. Soc Sci Med 1997; 45 (12) 1829-1843
- Junewicz A, Youngner SJ. Patient-satisfaction surveys on a scale of 0 to 10: improving health care, or leading it astray?. Hastings Cent Rep 2015; 45 (03) 43-51
- Mahapatra S, Nayak S, Pati S. Quality of care in cancer: an exploration of patient perspectives. J Family Med Prim Care 2016; 5 (02) 338-342
- Ware Jr JE, Davies-Avery A, Stewart AL. The measurement and meaning of patient satisfaction. Health Med Care Serv Rev 1978; 1 (01) 1 , 3–15
- Brédart A, Razavi D, Delvaux N, Goodman V, Farvacques C, Van Heer C. A comprehensive assessment of satisfaction with care for cancer patients. Support Care Cancer 1998; 6 (06) 518-523
- Hardy GE, West MA, Hill F. Components and predictors of patient satisfaction. Br J Health Psychol 1996; 1: 65-85
- Nguyen TV, Bosset JF, Monnier A. et al. Determinants of patient satisfaction in ambulatory oncology: a cross sectional study based on the OUT-PATSAT35 questionnaire. BMC Cancer 2011; 11: 526
- Lis CG, Rodeghier M, Gupta D. Distribution and determinants of patient satisfaction in oncology: a review of the literature. Patient Prefer Adherence 2009; 3: 287-304
- Naidu A. Factors affecting patient satisfaction and healthcare quality. Int J Health Care Qual Assur 2009; 22 (04) 366-381
- Bergenmar M, Nylén U, Lidbrink E, Bergh J, Brandberg Y. Improvements in patient satisfaction at an outpatient clinic for patients with breast cancer. Acta Oncol 2006; 45 (05) 550-558
- Patient Satisfaction. . n.d. Accessed July 6, 2021 from: https://en.wikipedia.org/wiki/Patient_satisfaction
- Heath S. Patient Satisfaction and HCAHPS: What It Means for Providers n.d. Accessed July 6, 2021 from: https://patientengagementhit.com/features/patient-satisfaction-and-hcahps-what-it-means-for-providers
- Pascoe GC. Patient satisfaction in primary health care: a literature review and analysis. Eval Program Plann 1983; 6 (3–4): 185-210 DOI: 10.1016/0149-7189(83)90002-2.
- Cleary PD. The increasing importance of patient surveys. Now that sound methods exist, patient surveys can facilitate improvement. BMJ 1999; 319 (7212): 720-721
- EORTC INPAT SAT 35 n.d. Accessed July 6, 2021 from: https://www.eortc.org/app/uploads/sites/2/2018/08/Specimen-IN-PATSAT32-English.pdf
- EORTC PAT SAT 33 n.d. https://qol.eortc.org/questionnaire/qlq-patsat-c33/ . Accessed July 6, 2021
- Kleeberg UR, Feyer P, Günther W, Behrens M. Patient satisfaction in outpatient cancer care: a prospective survey using The PASQOC questionnaire. Support Care Cancer 2008; 16 (08) 947-954
- Ware JE, Snyder MK, Wright W. Long form Patient Satisfaction Questionnaire (PSQ-III). 1976 . Accessed July 6, 2021 from: https://www.rand.org/content/dam/rand/www/external/health/surveys_tools/psq/psq3_survey.pdf
- Loblaw DA, Bezjak A, Bunston T. Development and testing of a visit-specific patient satisfaction questionnaire: the Princess Margaret Hospital Satisfaction With Doctor Questionnaire. J Clin Oncol 1999; 17 (06) 1931-1938
- Sahu U. Major Differences between Healthcare in the US and India. 2016 . Accessed July 6, 2021 from: https://www.huffingtonpost.in/utkarsh-sahu/a-tale-of-two-nations-ind_b_9261892.html
- Niranjan.. Major Differences in Healthcare between the USA and India; June. 2018 . Accessed July 6, 2021 from: https://ehealthclinics.in/major-differences-in-healthcare-between-the-usa-and-india/
- Shirley Lewis, Tabassum Wadasadawala, Pallavi Rane, Sudeep Gupta, Santam Chakraborty. et al. (2017) Validation of Patient Satisfaction Survey (PSS) for Outpatient Care Carried out in Multi-Disciplinary Breast Clinic. BAOJ Cancer Res Ther 03: 035
- Campbell DT, Fiske DW. Convergent and discriminant validation by the multitrait-multimethod matrix. Psychol Bull 1959; 56 (02) 81-105
- Kaiser HF. An index of factorial simplicity. Psychometrika 1974; 39: 31-36
- Bartlett MS. Properties of sufficiency and statistical test. J Chem Inf Model 2013; 53: 1689-1699
- Brédart A, Mignot V, Rousseau A. et al. Validation of the EORTC QLQ-SAT32 cancer inpatient satisfaction questionnaire by self- versus interview-assessment comparison. Patient Educ Couns 2004; 54 (02) 207-212
- Lis CG, Rodeghier M, Gupta D. Distribution and determinants of patient satisfaction in oncology: A review of the literature. Patient Prefer Adherence 2009; Nov 3; 03: 287-304 DOI: 10.2147/ppa.s6351.
Address for correspondence
Tabassum Wadasadawala, MD, DNBDepartment of Radiation Oncology, ACTREC, Tata Memorial Centre, Homi Bhabha National InstituteKharghar, Navi Mumbai, Maharashtra 410210IndiaPublication History
Received: 23 May 2020
Accepted: 06 August 2020
Article published online:
29 November 2021© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
References
- Pascoe GC. Patient satisfaction in primary health care: a literature review and analysis. Eval Program Plann 1983; 6 (3-4): 185-210
- Xesfingi S, Vozikis A. Patient satisfaction with the healthcare system: Assessing the impact of socio-economic and healthcare provision factors. BMC Health Serv Res 2016; 16: 94
- Sitzia J, Wood N. Patient satisfaction: a review of issues and concepts. Soc Sci Med 1997; 45 (12) 1829-1843
- Junewicz A, Youngner SJ. Patient-satisfaction surveys on a scale of 0 to 10: improving health care, or leading it astray?. Hastings Cent Rep 2015; 45 (03) 43-51
- Mahapatra S, Nayak S, Pati S. Quality of care in cancer: an exploration of patient perspectives. J Family Med Prim Care 2016; 5 (02) 338-342
- Ware Jr JE, Davies-Avery A, Stewart AL. The measurement and meaning of patient satisfaction. Health Med Care Serv Rev 1978; 1 (01) 1 , 3–15
- Brédart A, Razavi D, Delvaux N, Goodman V, Farvacques C, Van Heer C. A comprehensive assessment of satisfaction with care for cancer patients. Support Care Cancer 1998; 6 (06) 518-523
- Hardy GE, West MA, Hill F. Components and predictors of patient satisfaction. Br J Health Psychol 1996; 1: 65-85
- Nguyen TV, Bosset JF, Monnier A. et al. Determinants of patient satisfaction in ambulatory oncology: a cross sectional study based on the OUT-PATSAT35 questionnaire. BMC Cancer 2011; 11: 526
- Lis CG, Rodeghier M, Gupta D. Distribution and determinants of patient satisfaction in oncology: a review of the literature. Patient Prefer Adherence 2009; 3: 287-304
- Naidu A. Factors affecting patient satisfaction and healthcare quality. Int J Health Care Qual Assur 2009; 22 (04) 366-381
- Bergenmar M, Nylén U, Lidbrink E, Bergh J, Brandberg Y. Improvements in patient satisfaction at an outpatient clinic for patients with breast cancer. Acta Oncol 2006; 45 (05) 550-558
- Patient Satisfaction. . n.d. Accessed July 6, 2021 from: https://en.wikipedia.org/wiki/Patient_satisfaction
- Heath S. Patient Satisfaction and HCAHPS: What It Means for Providers n.d. Accessed July 6, 2021 from: https://patientengagementhit.com/features/patient-satisfaction-and-hcahps-what-it-means-for-providers
- Pascoe GC. Patient satisfaction in primary health care: a literature review and analysis. Eval Program Plann 1983; 6 (3–4): 185-210 DOI: 10.1016/0149-7189(83)90002-2.
- Cleary PD. The increasing importance of patient surveys. Now that sound methods exist, patient surveys can facilitate improvement. BMJ 1999; 319 (7212): 720-721
- EORTC INPAT SAT 35 n.d. Accessed July 6, 2021 from: https://www.eortc.org/app/uploads/sites/2/2018/08/Specimen-IN-PATSAT32-English.pdf
- EORTC PAT SAT 33 n.d. https://qol.eortc.org/questionnaire/qlq-patsat-c33/ . Accessed July 6, 2021
- Kleeberg UR, Feyer P, Günther W, Behrens M. Patient satisfaction in outpatient cancer care: a prospective survey using The PASQOC questionnaire. Support Care Cancer 2008; 16 (08) 947-954
- Ware JE, Snyder MK, Wright W. Long form Patient Satisfaction Questionnaire (PSQ-III). 1976 . Accessed July 6, 2021 from: https://www.rand.org/content/dam/rand/www/external/health/surveys_tools/psq/psq3_survey.pdf
- Loblaw DA, Bezjak A, Bunston T. Development and testing of a visit-specific patient satisfaction questionnaire: the Princess Margaret Hospital Satisfaction With Doctor Questionnaire. J Clin Oncol 1999; 17 (06) 1931-1938
- Sahu U. Major Differences between Healthcare in the US and India. 2016 . Accessed July 6, 2021 from: https://www.huffingtonpost.in/utkarsh-sahu/a-tale-of-two-nations-ind_b_9261892.html
- Niranjan.. Major Differences in Healthcare between the USA and India; June. 2018 . Accessed July 6, 2021 from: https://ehealthclinics.in/major-differences-in-healthcare-between-the-usa-and-india/
- Shirley Lewis, Tabassum Wadasadawala, Pallavi Rane, Sudeep Gupta, Santam Chakraborty. et al. (2017) Validation of Patient Satisfaction Survey (PSS) for Outpatient Care Carried out in Multi-Disciplinary Breast Clinic. BAOJ Cancer Res Ther 03: 035
- Campbell DT, Fiske DW. Convergent and discriminant validation by the multitrait-multimethod matrix. Psychol Bull 1959; 56 (02) 81-105
- Kaiser HF. An index of factorial simplicity. Psychometrika 1974; 39: 31-36
- Bartlett MS. Properties of sufficiency and statistical test. J Chem Inf Model 2013; 53: 1689-1699
- Brédart A, Mignot V, Rousseau A. et al. Validation of the EORTC QLQ-SAT32 cancer inpatient satisfaction questionnaire by self- versus interview-assessment comparison. Patient Educ Couns 2004; 54 (02) 207-212
- Lis CG, Rodeghier M, Gupta D. Distribution and determinants of patient satisfaction in oncology: A review of the literature. Patient Prefer Adherence 2009; Nov 3; 03: 287-304 DOI: 10.2147/ppa.s6351.