Psychometric evaluation of the Nurse Practitioner Satisfaction Survey (NPSS).

The purpose of this study was to identify and define underlying latent constructs within the concept of patient satisfaction with nurse practitioner delivered primary health care. The Nurse Practitioner Satisfaction Survey (NPSS), a 28-item, Likert-type, researcher developed instrument was completed by 300 clients presenting for primary health care visits in a hospital outpatient clinic. Factor analysis with promax rotation resulted in a three factor model explaining 70.77% of the variance. Eighteen items loaded on general satisfaction. Six items loaded on communication, and four items loaded on accessibility and convenience. Cronbach's alpha internal consistency reliability coefficients were .98, .83, and .76 for the three factors, respectively. The NPSS was found to be reliable and valid for measuring patient satisfaction with nurse practitioner delivered primary health care services. Keywords: patient satisfaction; nurse practitioner; occupational health; instrument The concept of patient satisfaction is a multifaceted and complex phenomenon. Among health care providers, an overall favorable acceptability and general positive level of satisfaction with nurse practitioner provided health care services has been demonstrated using a variety of health care satisfaction instruments. However, few studies, if any, have been implemented with the specific intent of explaining and gaining insight into those explicit complexities of human interaction occurring between a patient and nurse practitioner, which contribute to and characterize overall satisfaction with primary health care services. Furthermore, no instrument developed to specifically identify and measure those aspects of nurse practitioner care perceived as satisfactory and favorable to clients has been identified in the literature. This study is unique in that through development of the NPSS, it examines the core patient-nurse practitioner interface and identifies underlying constructs that contribute to and define satisfaction with nurse practitioner delivered primary health care in the occupational setting. The future viability and ongoing evolution of the nurse practitioner discipline depends upon the ability of the profession to identify, define, and perpetuate those traits, qualities, and aspects of primary care delivery perceived as beneficial and resulting in enhanced patient satisfaction. Various patient satisfaction surveys have addressed satisfaction with nurse practitioners only incidentally and secondarily, often in a broad context within the overall health care system. Although nurse practitioners have generally enjoyed an overall favorable acceptability as providers of health care services, the specific attributes of the interactions between nurse practitioners and patients contributing to and underlying such favorable receptions has not been identified or quantified. Research aimed at identifying and measuring the specific elements of client satisfaction with health care provided by nurse practitioners is severely lacking in the literature. Instruments developed for the specific purpose of identifying and delineating those aspects of nurse practitioner care perceived as satisfactory to clients has tremendous potential impact on the profession. Potential benefits gained through the development of nurse practitioner specific patient satisfaction instruments include the facilitation of practice pattern changes, improvement of the acceptability and viability of nurse practitioners as primary care providers, promotion of professional identity and growth, and enhancement of overall advanced nursing practice visibility, utilization, and marketability. Viewed in a contemporary context, amid a national health care arena plagued by physician shortages, lack of access, and an aging population, these research findings are of paramount significance to the ongoing evolution and professional development of the nurse practitioner discipline. …