Understanding and measuring patients' assessment of the quality of nursing care
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Updated: Jul 15, 2026

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Published on: February 16, 2011
Mary R Lynn1, Bradley J McMillen, Souraya Sidani
1School of Nursing, University of North Carolina at Chapel Hill, NC 27599-7460, USA. mary_lynn@unc.edu
Background:
Traditionally, patients have been considered incapable of evaluating the quality of care they receive, leading to their minimal involvement.
Objective:
To develop the Patient's Assessment of Quality Scale--Acute Care Version (PAQS-ACV) to provide a mechanism through which patients can evaluate meaningfully the nursing care they receive.
Methods:
Developed from qualitative interviews with patients, the original 90-item PAQS-ACV was tested with 1,470 medical surgical patients in 43 units across seven hospitals. The typical patient was a married, 50-year-old, high school-educated patient hospitalized for the fourth time. Every 10th patient was asked to complete the PAQS-ACV 2 weeks later.
Results:
After exploratory factor analysis, 45 items remained in five factors, accounting for 54% of the variance. Internal consistency estimates were above.83 for four of the five factors, with the fifth factor being.68. Test-retest reliability ranged from .58 to .71. Content validity was established and construct validity has been explored preliminarily by examining the relationship between the PAQS-ACV scores and patients' compliance.
Discussion:
Although the PAQS-ACV is a relatively new measure of quality nursing care, it has met many criteria for an adequate measure of quality care. The instrument fills a void in the assessment of quality by including patients in the direct evaluation of the care received.
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