Patient Experience Monitor (PEM): The Development of New Short-Form Picker Experience Questionnaires for Hospital Patients with a Wide Range of Literacy Levels

Figures & data

Figure 1 Method of survey development.

Figure 2 Flowchart of excluded questions.

Abbreviations: Q1-22, questions selected by expert team (Table 2); NA, not applicable>40%; EO, expert opinion.

Table 1 Characteristics of Respondents

Sample Description	PEM Adult Outpatients
	N=2506	Valid %
Gender
Male	1253	54.4
Female	1050	45.6
Age
16–20	24	1.0
21–30	94	4.1
31–40	153	6.6
41–50	263	11.4
51–60	550	23.9
61–70	726	31.5
> 70	492	21.4
Educational level
Early childhood education	35	1.6
Primary school	61	2.8
Lower secondary education	379	16.9
Upper secondary education	790	35.3
Tertiary education	230	10.3
Bachelor’s/Master’s or equivalent level	530	23.7
Doctoral or equivalent level	212	9.6

Table 2 Statistical Characteristics of Items

Picker Principle	Questions Selected by Expert Team Adult Outpatient	Ceiling >90% Positive Answers	Floor >90% Negative Answers	Missing >10%	Do Not Know >10%	NA >40%
FA, ES ES, CI, FA ES ES CI CC, ET CI, IR, ES ET IR, CI, ES ET AN, ET CI, CC ES IR IF, IR, CC IR, CI CC, CI CC, CI CC, CI AN, ET ES	Q1Did you have to wait at the clinic to see the nurse/doctor or was they on time?** Q2Were you told how long you would have to wait? (“go to”)** Q3Were the staff at the Outpatients Clinic reception friendly?** Q4Could other people hear what you were saying to the person on reception? Q5Did the staff at the Outpatients Clinic tell you what was going to happen to you? (“go to”)** Q6Did the doctors or nurses know what was written in your medical records?** Q7If you had a question for the doctor did you understand what they told you?** Q8Did you trust the doctors? (“go to”)** Q9If you had a question for one of the other members of staff at the Outpatients Clinic, did you understand what they told you? Q10Did you trust the other members of staff at the Outpatients Clinic? (“go to”) Q11Did you have enough time to talk to the doctor or other members of staff about your illness or problem?** Q12Sometimes at the Outpatient Clinic, members of staff say different things which may confuse you. Did this happen to you?** Q13Were you able to talk to anyone at the Outpatients Clinic about any worries or fears you had? Q14Were you involved in the decisions about your treatment?** Q15Were your family or someone close to you involved in the decisions about your treatment?** Q16Did anyone at the Outpatients Clinic explain to you the pros and cons of the treatment?** Q17Did a member of staff tell to you about possible side effects that you could have from any new medication?** Q18Did anyone at the Outpatients Clinic explain to you about any problems you needed to be aware of when you got home? Q19Did anyone speak to you about after care? For example: Should you make a new appointment or should you see your GP?** Q20How clean was the Outpatients Clinic? Q21Do you feel that the members of staff at the Outpatients Clinic treated you with respect?	42.8 22.0 85.1 42.4 80.9 92.0* 91.6* 91.3* 89.8 87.1 93.1* 79.5 76.9 88.1 93.4* 84.4 67.4 77.3 92.5* 98.4* 92.8*	3.3 60.1 1.1 8.6 14.5 1.0 0.6 1.2 0.5 1.3 1.8 3.4 12.1 2.6 2.3 1.3 15.4 12.5 2.1 0.0 0.3	0.0 0.0. 0.2 17.4* 1.5 0.4 0.2 2.3 0.4 20.4 2.3 2.8 1.9 1.9 2.3 2.6 2.8 2.6 2.5 2.3 2.8	0.8 1.2 0.3 9.6 3.1 1.2 n/a 0.1 0.2 9.6 n/a n/a n/a 1.7 n/a n/a n/a n/a 1.2 1.6 n/a	n/a 72.8 n/a n/a n/a 0.5 5.4 n/a 45.3* n/a n/a n/a 56.9* 24.6 34.9 23.2 54.9* 46.0* 23.2 n/a n/a

Abbreviations: FA, fast access to reliable healthcare; ET, effective treatment and trusted professionals; CC, continuity of care and smooth transitions; IR, involvement in decisions and respect for preferences, needs and values; CI, clear information and support for self-care; IF, involvement of and support for family and friends; ES, emotional support, empathy and respect; AN, attention for physical and environmental needs; NA, not applicable (it was not necessary/I do not need to/I did not have to/I did not spoke to); n/a, not applicable, go to, routing question; *, item eligible for exclusion; **, final selected item.

Table 3 Spearman Correlation Coefficients Between Final Selected Items PEM Adult Outpatient

	Q1	Q2	Q3	Q5	Q6	Q7	Q8	Q11	Q12	Q14	Q15	Q16	Q17	Q19
		0.104	0.201	0.169	0.111	0.073	0.123	0.085	0.096	0.097	0.099	0.114	0.113	0.052
Q1	2364		0.165	0.156	0.070	0.075	0.055	0.085	0.101	0.118	0.101	0.115	0.083	0.119
Q2	612	619		0.205	0.235	0.180	0.230	0.232	0.214	0.230	0.207	0.224	0.225	0.195
Q3	1950	497	1967		0.195	0.137	0.173	0.178	0.096	0.247	0.186	0.268	0.237	0.163
Q5	2259	588	1885	2276		0.359	0.386	0.357	0.304	0.416	0.339	0.407	0.223	0.273
Q6	2317	611	1931	2230	2335		0.330	0.315	0.276	0.370	0.249	0.374	0.249	0.225
Q7	2233	582	1868	2154	2217	2251		0.344	0.295	0.403	0.326	0.371	0.294	0.252
Q8	2305	603	1923	2218	2288	2241	2325		0.287	0.392	0.338	0.395	0.297	0.197
Q11	2309	604	1924	2228	2284	2202	2274	2329		0.325	0.258	0.321	0.238	0.216
Q12	2297	602	1918	2216	2272	2187	2260	2293	2317		0.708	0.527	0.369	0.355
Q14	1699	447	1448	1655	1688	1647	1677	1676	1675	1712		0.358	0.237	0.310
Q15	1489	393	1266	1434	1478	1445	1469	1472	1462	1264	1499		0.463	0.294
Q16	1757	463	1502	1696	1739	1699	1735	1732	1735	1479	1310	1770		0.290
Q17	1003	290	876	970	998	977	990	989	994	874	781	951	1009
Q19	1727	448	1484	1684	1712	1674	1704	1710	1700	1356	1207	1425	871	1742

Notes: Correlations are in the right-upper triangle, numbers in the left-lower triangle. Correlations > 0.7 are shaded in red.