• Lawson B Eksteen and Robert J Mash.
• Division of Family Medicine and Primary Care, Stellenbosch University, Cape Town, South Africa.
• Fam Pract. 2019 May 23; 36 (3): 310316310-316.

BackgroundEffective primary care is vital for improving health outcomes. Patient-centred consultations are important and one way of assessing this is to evaluate patient satisfaction. The Medical Interview Satisfaction Scale (MISS) has not been used in South Africa.AimTo test validity and reliability of the MISS and evaluate patient satisfaction with consultations.SettingPrimary care facilities in the Helderberg sub-district, South Africa.MethodsThe MISS tool was adapted and validated by a panel of experts. The internal consistency was evaluated on 150 consultations. The level of patient satisfaction on 23 items, in consultations by nurses and doctors, was measured. Respondents indicated agreement with each item on a scale (1 = very strongly disagree, 7 = very strongly agree).ResultsThe wording of the items were adapted and translated into Afrikaans and Xhosa. There was good overall internal consistency (Cronbach alpha 0.889), but not in all subscales. Patients were most satisfied with rapport (Median score 6.2 (IQR 5.3-5.9)) and understanding of their concerns, fears and beliefs (5.7 (IQR 5.1-6.3)). They were less satisfied with the ability to foster an acceptable management plan (5.5 (IQR 4.5-6.5)) and with accuracy of information (5.0 (IQR 4.2-5.8)). Scores for nurses and doctors were not significantly different.ConclusionFurther work is needed to improve the reliability of MISS subscales in the South African context and the best internal consistency was found with 21 items. Patients showed high levels of satisfaction with primary care consultations, although other studies suggest this may reflect low expectations rather than high quality consultations.© The Author(s) 2018. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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