Community Based Healthcare Services Satisfaction Scale Among Older Adults Development and Psychometric Evaluation

Community home-based elderly healthcare services play a crucial role in combating the aging trend. However, China's community home-based elderly healthcare is still in its infancy, and the quality of these services must be enhanced. The satisfaction of older adults as a significant indicator of older adults healthcare services quality is crucial for promoting the enhancement of service quality. Currently, an appropriate instrument to assess community home-based elderly healthcare services satisfaction is limited. The present study aimed to develop and examine the community home-based elderly healthcare services satisfaction scale (CHEHSSS).

Developing and assessing the scale was carried out in two phases: Phase I involved a literature review and Delphi to explore the themes of satisfaction for community home-based elderly healthcare services and instrument development; Phase II established construct validity of the scale using a sample of 439 elderly in Tianjin. Data from the questionnaire were analysed using Item analysis, exploratory factor analysis, confirmatory factor analysis, and internal consistency. Analysis results were used to determine the reliability and validity of the developed scale.

The scale was developed and validated in two phases. Phase I involved a literature review and Delphi expert consultation (n = 15) to identify satisfaction domains and generate items. Phase II evaluated psychometric properties using a cross-sectional sample of 439 older adults in Tianjin, China. Item analysis, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and reliability tests (Cronbach's α, split-half reliability) were conducted. The results showed seven factors including diagnosis and treatment capacity, professional skills, preventive care, care and respect, transitional care, medical circumstances, and service attitude were generated by exploratory factor analysis, and these factors explained 78.463% of the total variance. Cronbach's α of the community home-based elderly healthcare services satisfaction scale was 0.896.

The establishment of the tool will help to accurately assess the satisfaction of older adults with community home-based healthcare services, which can inform the construction of policies aimed at promoting the quality improvement of community home-based elderly healthcare services.