Sources of systematic error in instruments measuring satisfaction with home care

The concept of systematic error (SE) is used in this review as a framework for appraising the only two studies reporting psychometric testing of instruments of home-care satisfaction (HCS). The development of each tool is summarized. General sources of SE are discussed relative to instrumentation, the process of measurement, and participants. Sources of SE that researchers in HCS have tried to remedy in each category are covered. The typical approaches to those problems are critically analyzed relative to the validity of the construct of HCS. Ideas are proposed to enhance the empirical grounding of the construct through (a) eliciting and analyzing data about expectations as well as data about satisfaction and (b) counteracting the interaction among response set, direct referent items, and skewness in studies of HCS.