Comparing doctor- and nurse-led care in a sexual health clinic: patient satisfaction questionnaire

Abstract

Background. A new model of comprehensive care nurse‐led clinics has enabled experienced genitourinary medicine nurses to co‐ordinate the first‐line, comprehensive care of female patients presenting with sexually transmitted infections and other sexual health conditions and issues. Aim. This paper describes the development of a patient satisfaction questionnaire to compare the satisfaction of women attending nurse‐led or doctor‐led clinics at a central London genitourinary medicine clinic. Methods. A previously validated questionnaire was adapted using the findings of qualitative interviews exploring patient expectations of the service. The draft questionnaire was tested for internal consistency, sub‐scale homogeneity, construct validity and stability. The final version consisted of a 34 item, five‐point Likert scale, which was found to be both reliable (Cronbach's α 0·91) and stable (test–retest 0·95). There was some evidence of construct validity. The questionnaire was then distributed to a convenience sample of 132 women attending a nurse‐led clinic and 150 seen at a doctor‐led clinic. Results. There was a 90% response rate. The median total satisfaction scores, out of a total of five, were 4·47 and 4·30 for the nurse‐led and doctor‐led groups, respectively (P = 0·05). Significantly higher scores on the sub‐scales measuring quality and competence of technical care (P < 0·001), provision of information (P = 0·01) and overall satisfaction (P = 0·01) were seen for the nurse‐led group. No significant differences were found in the sub‐scales measuring service attributes and specific attributes of interpersonal relationships. Conclusion. The rigorous development, piloting and testing phases of this satisfaction questionnaire led to reliable and valid results. This study demonstrated that nurse‐led clinics within this service are an acceptable alternative to the existing doctor‐led clinics.