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Using data collected in 1962 and 1963 from a sample of 861 male and female National Merit Scholarship participants, the investigators studied the validity of 16 of the 18 CPI scales. In particular, the study was designed to discover whether the common factor variance of the CPI scales carries the valid scale variance or whether the unique scale variance contains the information critical to scale validity. Each CPI scale score was broken down into a portion attributable to the two principal factor scales (Nichols and Schnell, 1963) and a portion not so attributable. With one exception, the tolerance scale, the CPI scales showed considerable validity. That is, they were substantially more strongly related to particular criterion variables (8 to 20 criteria) than to variables in general (178 variables). With four exceptions, the valid scale variance was carried in the common factor portion rather than in the unique portion of the scale variance. The exceptions to this rule showed the valid variance being shared roughly equally between the common factor and unique portions of the scale variance. The investigators concluded that for the most part the factor scales do indeed capture the valid variance in the CPI profile.

This paper describes an instrument design effort aimed at measuring patient- satisfaction among older (65 years and over) subscribers of HMOs. The study was conducted in a multi-satellite prepaid group practice in Buffalo, New York. In order to be able to construct a satisfaction measure that would reflect the interests of the actual consumers of HMO-services, a series of four focused group interviews were held with 24 randomly selected elderly enrollees. The substantive content of these interviews was systematically analyzed for both topics and ideas, yielding a total of 173 distinct ideas about the perceived satisfaction with the services received expressed over 3,176 lines of narrative. From this substantive pool, sixty attitudinal statements were constructed with the ideas represented in these statements being proportional to the number of lines of transcribed discussion devoted to each topic. This 60-item Older Patient Satisfaction Scale (OPSS) was submitted to a systematic sample of 229 elderly HMO subscribers. They also were asked to complete two existing scales the Ware PSQ, and the Larsen CSQ-8. Factor analysis performed on the OPSS-items yielded 14 primary factors of geriatric patient satisfaction, two second-order and one third order general factor. As the second-order factors accounted for the largest proportion of the common variance, those items of the original 60-item OPSS were identified that had highest loadings on these second-order factors, yielding 7 such items for one and 5 for the other. These scales had alpha-reliabilities of .83 and .80, respectively. It was also found that the OPSS had good convergent validity with the PSQ and CSQ-8. The overall psychometric properties identified for the OPSS, as well as the fact that it was constructed from a health-care consumer's perspective, makes it well suited for use with a unique and rapidly expanding geriatric patient population.