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Development and Testing of a New Instrument to Measure Patient Satisfaction With Health Care in Inflammatory Bowel Disease: The CACHE Questionnaire

Casellas, Francesc MD, PhD*; Ginard, Daniel MD, PhD; Vera, Isabel MD, PhD; Torrejón, Antonio RN, BSc*on behalf of GETECCU

doi: 10.1097/MIB.0b013e31827febd1
Original Clinical Articles

Background: Currently, there is no tool to evaluate satisfaction of patients with inflammatory bowel disease (IBD) with health care services. The objective of this study was to develop and test a new specific instrument to measure satisfaction with health care in patients with IBD.

Methods: The questionnaire was developed using a literature review, a focus group with clinical experts, and administration of a provisional version to 20 patients with IBD. The final version of the questionnaire was validated in a longitudinal multicenter study in adult patients with IBD. The instrument’s underlying dimension structure was analyzed using factor analysis, and its feasibility, reliability, and validity were assessed.

Results: The final version of the CACHE questionnaire contains 31 items scored on a 5-point Likert-type scale. Scores were standardized to a range from 0 (minimum satisfaction) to 100 (maximum satisfaction). Factor analysis revealed 6 factors (staff care, clinician care, facilities, information, center accessibility, and support received), which explained 56% of variance. Overall, 91% of patients answered all items. Cronbach’s alpha for the overall score was 0.93. There were no statistically significant correlations between the overall score and sociodemographic and clinical variables, but there was a statistically significant correlation between the time spent in the waiting room and the item measuring satisfaction with that aspect. There were no statistically significant changes in the overall score between the visits. The effect size was 0.016.

Conclusions: The CACHE questionnaire covers aspects relevant to the assessment of health care quality in patients with IBD and has proved to be feasible, reliable, and valid.

Article first published online 6 February 2013

*Unitat Atenció Crohn-Colitis, Hospital Universitari Vall d’Hebron, Ciberehd, Barcelona, Spain

Servicio de Aparato Digestivo, Hospital Universitari Son Espases, Palma de Mallorca, Spain

Servicio de Gastroenterología y Hepatología, Hospital Universitario Puerta de Hierro, Majadahonda, Spain.

Reprints: Francesc Casellas, Unitat Atenció Crohn-Colitis, Hospital Universitari Vall d’Hebron, Pg. Vall d’Hebron 119, 08035 Barcelona, Spain (e-mail:

The study was sponsored by the GETECCU Group. This group received financial support.

The study was coordinated by IMS Health and funding to carry out the study was provided by MSD.

The authors have no conflicts of interest to disclose.

Members of the CACHE Group are listed in Appendix 1.

Received June 04, 2012

Accepted June 04, 2012

© Crohn's & Colitis Foundation of America, Inc.
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