Development of a short form of the Quality from the Patient's Perspective (QPP) questionnaire

Patients' views on the quality of care are important and it is desirable that these can be assessed using short, yet valid and reliable instruments. The aim of the work reported here was to develop and test a short version of an established questionnaire: Quality from the Patient's Perspective (QPP). Patients (n=162, 79% response rate) receiving care at medical and surgical departments in two Swedish hospitals responded to the original QPP as well as to a newly developed short version. An ethical research committee approved the study. Pearson correlations were computed between the long and short forms and differences between means were analysed with t-tests. Reliability was estimated by computing Cronbach alpha coefficients. Correlations of acceptable size were found between the short form and the original QPP. The short form also had acceptable reliability coefficients. The strengths of the work are that the items in the short version are derived from a patient perspective and are formulated in words used by patients; the items still have a theoretical foundation, which makes the interpretation of results more meaningful; global formulations such as "What do you think about your care?" have been avoided; the short format should make the questionnaire more attractive for many patients to respond to. Limitations are that results indicate that the short form does not fully measure what the long form does. Therefore, when the short form is used in practice, a two-step procedure is suggested, where a follow-up is done with a selection of items from the original long form. This selection could be restricted to areas where problems may be suspected, based on the results from the short form.