HCCQ (Patient Form)

HCCQ (Patient form)

Instruction:

We are running a study to improve the quality of healthcare.

This questionnaire concerns your experience with the healthcare provider you have just encountered.

Please, read with attention each question and answer putting a check on the appropriate answer.

Please, answer to all the questions.

The questionnaire is anonymous.

Thank you very much.

Date ______

Your age: ______years

Your gender: Male______Female ______

Your job: ______

Your level of education: how many years you have attended school? ______years

Not at all / A little / Some what / Very much / Completely
1. / The healthcare provider looked at me in the eyes when I was talking / 1 £ / 2 £ / 3 £ / 4 £ / 5 £
2. / I felt my needs were being respected / 1 £ / 2 £ / 3 £ / 4 £ / 5 £
3. / I was asked questions in a clear manner / 1 £ / 2 £ / 3 £ / 4 £ / 5 £
4. / I was asked questions in an aggressive manner / 1 £ / 2 £ / 3 £ / 4 £ / 5 £
5. / I received clear and precise information / 1 £ / 2 £ / 3 £ / 4 £ / 5 £
6. / I have been given answers in an aggressive manner / 1 £ / 2 £ / 3 £ / 4 £ / 5 £
7. / I have been treated with kindness / 1 £ / 2 £ / 3 £ / 4 £ / 5 £
8. / I have been treated in a rude and hasty manner / 1 £ / 2 £ / 3 £ / 4 £ / 5 £
9. / The healthcare provider addressed me with a smile / 1 £ / 2 £ / 3 £ / 4 £ / 5 £
10. / The healthcare provider was able to resolve my problem / 1 £ / 2 £ / 3 £ / 4 £ / 5 £
11. / The healthcare provider was able to manage the consultation / 1 £ / 2 £ / 3 £ / 4 £ / 5 £
12. / The healthcare provider showed to be able to stay calm / 1 £ / 2 £ / 3 £ / 4 £ / 5 £
13. / The healthcare provider showed respect for my privacy / 1 £ / 2 £ / 3 £ / 4 £ / 5 £

INFORMATION FOR THE RESEARCHER

Permission to use HCCQ is granted for research purposes and not for profit.

The validation study (Gremigni, Sommaruga, Peltemburg, 2008) should be cited in any publications resulting from its use.

It is possible to substitute “the healthcare provider” to adapt the HCCQ to the setting of the research (e.g., “the nurse”; “the physiotherapist” etc.). Any other changes should be communicated to:

Prof. Paola Gremigni; e-mail address: or to

Dr. Marinella Sommaruga; e-mail address:

Validation study

Gremigni P, Sommaruga M, Peltenburg M. (2008) Validation of the Health Care Communication Questionnaire (HCCQ) to measure patients evaluation of hospital personnel communication skills. Patient Education and Counseling, 71, 57–64.

SCORING:

Problem Solving (sum up 4 items): 10, 11, 12,13

Respect (sum up 4 items): 3, 5, 2, 7

Lack of Hostility (sum up 3 items): 4, 6, 8 - all items are reverse scored

Non-verbal Immediacy (sum up 2 items): 1, 9.

Other publications:

Miglioretti M., Nasorri C., Passoni E., Sommaruga M., Gremigni P. (2007). Efficacia di un percorso formativo sulla comunicazione operatore sanitario-paziente in cardiologia riabilitativa. Psicologia della salute, 2, 87-100.

Sommaruga M., Gremigni P., Della Porta P. (2009). Esperienze di pazienti e utenti durante una breve interazione comunicativa con il personale ospedaliero. Psicologia della salute, 1, 5-14.

HCCQ (Healthcare professional form)

Instruction:

We are running a study to improve the quality of healthcare.

This questionnaire concerns your experience with the patients you have just encountered.

Please, read with attention each question and answer putting a check on the appropriate answer.

Please, answer to all the questions.

The questionnaire is anonymous.

Thank you very much.

Date ______

Your age: ______years

Your gender: Male______Female ______

Your job: ______

Your level of education: how many years you have attended school? ______years

Not at all / A little / Some what / Very much / Completely
1. / I looked at the patient in the eyes when he/she was talking / 1 £ / 2 £ / 3 £ / 4 £ / 5 £
2. / I have respected the patient’s needs / 1 £ / 2 £ / 3 £ / 4 £ / 5 £
3. / I made requests in a clear manner / 1 £ / 2 £ / 3 £ / 4 £ / 5 £
4. / I made requests in an aggressive manner / 1 £ / 2 £ / 3 £ / 4 £ / 5 £
5. / I gave the patient clear and precise information / 1 £ / 2 £ / 3 £ / 4 £ / 5 £
6. / I gave answers in an aggressive manner / 1 £ / 2 £ / 3 £ / 4 £ / 5 £
7. / I treated the patient with kindness / 1 £ / 2 £ / 3 £ / 4 £ / 5 £
8. / I treated the patient in a rude and hasty manner / 1 £ / 2 £ / 3 £ / 4 £ / 5 £
9. / I addressed the patient with a smile / 1 £ / 2 £ / 3 £ / 4 £ / 5 £
10. / I was able to resolve the patient’s problem / 1 £ / 2 £ / 3 £ / 4 £ / 5 £
11. / I was able to manage the situation even in presence of urgency and long queue / 1 £ / 2 £ / 3 £ / 4 £ / 5 £
12. / I showed to be able to stay calm / 1 £ / 2 £ / 3 £ / 4 £ / 5 £
13. / I showed respect for the patient’s privacy / 1 £ / 2 £ / 3 £ / 4 £ / 5 £