Development and Validation of the Preliminary Version of Brief Inpatient Satisfaction Scale (BISS)

Document Type : Research Paper


1 Faculty of Management, University of Tehran, Iran

2 Department of Assessment and Measurement, Faculty of Psychology and Education, Allameh Tabatabai University, Tehran, Iran

3 Department of Psychology, University of Tehran, Tehran, Iran

4 Pharmaceutical Sciences Branch, Islamic Azad University, Tehran, Iran


Background and Objectives: Questionnaire-based survey is the most common way of assessing patient satisfaction. However, most relevant survey instruments have been developed in western countries, and valid and reliable context-specific survey tools in this area are lacking. To help filling this gap, in this study we have developed and validated the preliminary version of the novel Brief Inpatient Satisfaction Scale (BISS) to be used in an Iranian context.   Methods: Initially 32 items were included by reviewing different aspects of patient satisfaction in the literature. A sample of 637 patients from Moheb hospital (Tehran, Iran) was surveyed for the purpose of instrument evaluation in autumn of 2013. In various steps of scale development, 6 items were discarded due to psychometric reasons. Content validity was examined by seeking experts’ opinions, the internal consistency reliability by Cronbach’s alpha, and the construct validity was tested using correlation analysis.   Findings: A 26-item survey for measuring patient satisfaction in an Iranian context was developed. Exploratory factor analysis yielded a four-factor solution. The extracted factors were named physician care, nursing care, living arrangements, and communication. Two factors were perfectly loaded while two others showed cross-loadings. An internal consistency reliability of 0.91 was observed for the entire instrument. The subscales showed alpha coefficients of 0.85, 0.86, 0.75, and 0.71, respectively.   Conclusions: The preliminary version of BISS could be used to evaluate patient satisfaction in an Iranian context with adequate reliability. Further improvement should focus on improving the reliability of living arrangements, and communication dimensions.