Development and validation of a new questionnaire measuring treatment satisfaction in patients with non-valvular atrial fibrillation: SAFUCA^sup

Objective To develop a new questionnaire with good psychometric properties to measure satisfaction with medical care in patients with non-valvular atrial fibrillation. Method The initial instrument was composed of 37 items, arranged in 6 dimensions: efficacy, ease and convenience, impact on daily activities, satisfaction with medical care, undesired effects of medication, and overall satisfaction. Items and dimensions were extracted from reviewing existing instruments, 3 focus groups with chronic patients, and a panel of 8 experts. Additionally, 3 visual analog scales measuring quality of life, effectiveness, and overall satisfaction were administered. A convenience sample of 119 patients was used for item reduction. Classic psychometric theory and item analysis techniques were used (exploratory factor and confirmatory factor analysis, test-retest, and correlation with visual scales). A validation sample of 230 patients was used to assess convergent validity, and an additional 220 patients sample was used to discriminate between treatment and compliance groups. Results The questionnaire was reduced in length to 25 items, but the impact dimension had split in treatment inconvenience and treatment control. Overall reliability was high ([alpha] = 0.861) with acceptable dimensional reliabilities ([alpha] = 0.764-0.908). Individual dimensions correlated to varying degrees. Test-retest correlations were high (r = 0.784-0.965), and correlations with visual and already validated scales were substantial. Differences were detected between antivitamin K and new-oral-anticoagulant treatments in several dimensions (p < 0.05). Treatment satisfaction was related with compliance. Conclusion This new 25-item questionnaire has good psychometric properties for measuring satisfaction with medical care in patients with this condition. It is capable of detecting differences between different treatments.