The home care satisfaction measure: A client-centered approach to assessing the satisfaction of frail older adults with home care services

Objectives. The Home Care Satisfaction Measure (HCSM) is an easy to administer, psychometrically sound instrument based on consumer-defined notions of satisfaction, including perspectives of ethnic minorities. The HCSM provides an overall home care satisfaction score and subscale scores for 5 common services, all on a 0-100 scale. Methods. Focus groups with African American, Hispanic, and non-Hispanic White older adults were audiotaped. Tapes were transcribed and analyzed with grounded theory methods. Correlational and common factor analyses were conducted to select items, and the instrument was field tested with 228 frail, low-income, older home care recipients. Results. Test-retest reliabilities ranged from .68 to .88, with high internal consistency reliabilities. Substantial concurrent validity was achieved for subscale and overall HCSM scores. Home care satisfaction was not related to gender, age or race but was negatively associated with physical disability. Significant social desirability effects were found. Discussion. In the increasingly important area of home care, the HCSM is the first measure developed on the basis of the views of older consumers that also meets standard psychometric criteria. The HCSM provides a consumer-based indicator of quality and can be used to examine changes in satisfaction over time and differences among providers or within a single agency.