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Spanish-Language Version of the MedRisk Instrument for Measuring Patient Satisfaction With Physical Therapy Care (MRPS): Preliminary Validation

PF Beattie, PT, PhD, OCS, is Clinical Associate Professor, Program in Physical Therapy, Department of Exercise Science, Arnold School of Public Health, and the Department of Developmental Biology and Anatomy, School of Medicine, University of South Carolina, Columbia, SC 29208 (USA).
RM Nelson, PT, PhD, FAPTA, is Professor, Department of Physical Therapy, Lebanon Valley College, Annville, Pa, and Vice President, Expert Clinical Benchmarks, LLC, King of Prussia, Pa.
A Lis, PT, MS, is Associate Clinical Director, Program of Ergonomics and Biomechanics, Occupational and Industrial Orthopedic Center, NYU Hospital for Joint Diseases, and Instructor, New York University, New York, NY.

pbeattie{at}gwm.sc.edu

Background and Purpose: An instrument that provides valid measurements of satisfaction with physical therapy care for Spanish-speaking patients will enhance communication and ensure their representation in quality assurance analyses and research on health care disparities. The purpose of this investigation was to provide preliminary information on the factor structure, group- and individual-level reliability, and criterion-referenced validity of measurements obtained from a Spanish-language version of the MedRisk Instrument for Measuring Patient Satisfaction With Physical Therapy Care (MRPS).

Subjects: A total of 203 Spanish-speaking patients in the New York City area participated in this study.

Methods: Consenting subjects completed a 20-item MRPS after discharge from outpatient physical therapy care. Several translators performed "forward" and "backward" translation of the MRPS, followed by consensus agreement on item structure. Factor structure was investigated using item-correlation and exploratory factor analysis. Group-level reliability for single test administration was assessed using the Cronbach alpha, and individual-level reliability was assessed by calculating the standard error of the measure (SEM). Concurrent validity was tested by comparing the item scores and mean scores of factors to global measures of satisfaction.

Results: The means of individual item scores (1–5) ranged from 3.22 for "I did not wait too long" to 4.80 for "My therapist treated me respectfully." There were no sex-based differences in item scores. Exploratory factor analysis suggested a 2-factor solution: a 7-item "external" factor and a 3-item "internal" factor. The correlations (r) of the mean scores from these factors with the 2 global measures ranged from .59 to .82. The SEM was 0.16 for the internal factor and 0.25 for the external factor.

Discussion and Conclusion: The underlying factor structure of the Spanish-language version of the MRPS was identical to the English-language version. Our findings provide preliminary support for the reliability and validity of measurements obtained from the Spanish-language version of the MRPS. Further study is needed to assess the stability of these findings in other samples. As with English-speaking patients, Spanish-speaking patien's satisfaction with physical therapy care is most strongly linked to the professional behavior of the clinician.