Confirmatory factor analysis and sample invariance of the Chinese Patient Satisfaction Questionnaire (ChPSQ-9) among patients with breast and lung cancers

Objectives: Previous exploratory factor analysis of the 9-item ChinesePatient Satisfaction Questionnaire (ChPSQ-9) identified two dominantfactors: doctor and nurse. The present study employed confirmatory factoranalysis (CFA) to examine the factorial invariance of the ChPSQ-9between and within samples of Chinese patients with breast or lung cancer.Methods: Longitudinal data were analyzed from Chinese breast and lungcancer patients who had completed the ChPSQ-9 during their first outpatientvisit, at 3 months, and at 6 months after baseline. CFAs tested the fitof a one-factor model, a hierarchical model that comprised a general latentfactor and two first-order factors, and a correlated model that comprisedtwo correlated first-order factors to the data. The factorial invariance ofthe ChPSQ-9 between six independent samples across time was investigatedusing multigroup CFAs.Results: The CFA’s results demonstrated a better fit of the correlatedmodel over the one-factor model and the hierarchical model in the breastand lung cancer samples. The correlated model showed evidence of crosssampleand longitudinal factorial invariance. Patients were generally satisfiedwith services provided by doctors and nurses. Internal consistency ofthe scale was also good for both cancer samples across time.Conclusions: The ChPSQ-9 is a valid and reliable instrument to beemployed among breast and lung cancer patients, in clinical settings orintervention research, to evaluate group differences in patient satisfactionand its association with intervention effectiveness.