The patient's perception of care is an important indicator of health care quality. Valid and reliable measures of patients’ perceptions of patient-centered care are vital to investigations that relate the quality of care to patient outcomes, health care system characteristics, and patient characteristics. Based upon a qualitative study of patients’ perspectives of high quality nursing care (Radwin, 2000), the Oncology Patients' Perception of the Quality of Nursing Care Scale (OPPQNCS©) (Radwin, Alster, & Rubin, 2003)  measures patient-centered nursing care and comprises four subscales: responsiveness, individualization, coordination and proficiency. The OPPQNCS has been translated into Spanish by Dr. Radwin, into Finnish by Dr. Riita Suhonen, into Arabic by Dr. Gulbeyaz Can, and into Hebrew by Aluma Skatt.

Responsiveness is conceptually defined as the degree to which the nurse demonstrates that she or he is able to meet patient needs in caring and attentive manner. Individualization is the degree to which the nurse personalizes care according to the patient's feelings, preferences, and desired level of involvement in care. Coordination is the degree of communication among other nurses and the patient. Proficiency is the degree to which the nurse provides knowledgeable, skillful nursing care.

The OPPQNCS was originally devised to measure oncology patients’ perceptions of patient-centered care. The scale was subsequently assessed in a sample of hospitalized medical-surgical patients in Finland and found to be psychometrically sound (Suhonen, Schmidt, & Radwin, 2007), providing assurances that the OPPQNCS can be used with non-cancer patient populations.

PSYCHOMETRIC PROPERTIES

Construct Validity of the original 45-item OPPQNCS was examined with a principal component method of exploratory factor analysis using a promax (oblique) rotation. The principal components analysis (PCA) revealed that four factors accounted for 80.5% of the variance. Iterative analysis yielded a 40-item scale (long form) with four domains:  responsiveness, individualization, coordination, and proficiency.  Stepwise regression techniques yielded a short form containing 18 items to measure the same domains.

Construct validity was further assessed with a confirmatory factor analysis (CFA) in a study of patient-centered nursing care for a racially diverse sample of patients (N=215) (Radwin, Cabral, & Wilkes, in press). The four subscales best fit the data with all original items (Responsiveness, Coordination) or with two items removed (Proficiency, Individualization). Internal consistency reliability for these subscales was evaluated with coefficient alpha: .86 for the Responsiveness subscale, .83 for the Individualization subscale, .83 for the Coordination subscale, and .85 for the Proficiency subscale Could we please combine this paragraph with the next one?Fit statistics to assess the measurement model included comparative fit index (CFI; criterion>.95), Tucker-Lewis Index (TLI; criterion>.95), root mean square error of approximation (RMSEA; criterion<.06); and the standardized root mean square residual (SRMR; criterion <.08). Fit statistics for the subscales were: Responsiveness: CFI=.981, TLI=.962, RMSEA=.094; SRMR=.028; Individualization: CFI=1.00; TLI=1.00, RMSEA=<.001; SRMR=<.001; Coordination: CFI=1.00; TLI=1.00, RMSEA=<.001; SRMR=<.001; Proficiency: CFI=1.00; TLI=1.00, RMSEA=<.001. Dr. Radwin recommends that the coefficient alphas and fit statistics be considered supporting evidence for the OPPQNCS’ internal consistency reliability and construct validity. However, users may wish to continue to use the 18-item scale rather than the 14-item scale resulting from the confirmatory factor analysis. Please contact Dr. Radwin for more information.

Reliabilities estimations for the long and short versions

Long Version:  Internal consistency reliability of the OPPQNCS© was assessed using coefficient alpha.  Coefficient alpha of the total 40-item scale was .99; .99 for the Responsiveness subscale, .97 for the Individualization subscale; .87 for the Coordination subscale, and .95 for the Proficiency subscale

Long Version Sample [PDF]

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Short Version: Coefficient alpha of the total 18-item short form was 0.97; 0.95 for the Responsiveness subscale; 0.93 for the Individualization subscale, 0.87 for the Coordination subscale; and 0.95 for the Proficiency subscale.

Short Version Sample [PDF]

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REFERENCES AND OTHER RELEVANT ARTICLES
Radwin, L. (2000). Oncology patients’ perceptions of quality nursing care. Research in Nursing & Health, 23, 179-190.  Qualitative study providing the basis for scale development.

Radwin, L., Alster, K., & Rubin, K. (2003) The development and psychometric testing of the Oncology Patients’ Perceptions of the Quality of Nursing Care Scale (OPPQNCS). Oncology Nursing Forum, 30, 283-290.

Radwin, L., Cabral, H., & Wilkes, G. (in press). Relationships between patient-centered cancer nursing interventions and desired health outcomes in the context of the health care system. Research in Nursing & Health. OPPQNCS confirmatory factor analyses; OPPQNCS used to operationalize patient-centered care in the path model analysis.

Radwin, L. (2003). Cancer patient demographic characteristics and ratings of patient-centered nursing care. Journal of Nursing Scholarship, 35, 365-370. OPPQNCS used to examine differences in patients’ perceptions as related to age, gender, race, and educational levels.

Suhonen, R., Schmidt, L. &  Radwin, L. (2007). Measuring individualized nursing care: Assessment of reliability and validity of three scales. Journal of Advanced Nursing. 59, 77-85. Psychometric properties in Finnish hospitalized medical-surgical patients.