Italian Validation of the Patient Satisfaction With Nursing Care Quality Questionnaire (PSNCQQ): A Multicenter Psychometric Study

Abstract

Background The Patient Satisfaction with Nursing Care Quality Questionnaire (PSNCQQ) is one of the most widely used international instruments for assessing patient‐perceived nursing care quality. However, no validated Italian version is currently available. Aim To evaluate the psychometric properties of the Italian version of the PSNCQQ in a large sample of hospitalized adult patients. Methods A multicenter cross‐sectional study was conducted in five public hospitals in Italy. The PSNCQQ was translated and culturally adapted according to international guidelines. The total sample (N = 698) was randomly divided into two independent subsamples for exploratory factor analysis and confirmatory factor analysis. Models were estimated using robust weighted least squares with adjustment for hospital clustering. Competing factorial models were tested. Internal consistency was assessed using Cronbach’s alpha and McDonald’s omega, whereas convergent and construct validity were examined through average variance extracted, composite reliability, and correlations with four global satisfaction indicators. Results Exploratory factor analysis supported a two‐factor structure distinguishing core nursing care, comprising 14 items, from continuity‐of‐care and discharge‐related processes, comprising five items. Confirmatory factor analysis showed that the correlated two‐factor model provided a better fit than the strictly unidimensional model, whereas the bifactor model was not retained. Internal consistency was excellent for core nursing care (ω = 0.964), continuity of care (ω = 0.894), and the total scale (α = 0.95; ω = 0.95). Average variance extracted and composite reliability values supported convergent validity. PSNCQQ scores were positively associated with global satisfaction indicators (r = 0.45–0.88; p < 0.001), with the strongest associations observed for the core nursing care dimension. Conclusions In the Italian context, patient satisfaction with nursing care is best represented by two related but distinct domains. The Italian PSNCQQ demonstrated robust measurement properties and supports the interpretation of both subscale and total scores for evaluating patient experience in hospital settings. Implications for Nursing Management The PSNCQQ can provide nurse managers with a reliable patient‐reported indicator for monitoring nursing‐sensitive quality across hospital units. Its separate assessment of core nursing care and continuity‐related processes may support benchmarking, quality‐improvement planning, and targeted organizational interventions in bedside care, discharge preparation, and care coordination.