Satisfaction of hypertensive users with primary health care services in Brazil: a validation study

Objective. To validate an instrument to evaluate the level of satisfaction of hypertensive adults with hypertension control services in the context of primary health care in Brazil. Methods. The study was carried out in 2009, in two municipalities located in Northeast Brazil. A probabilistic sample of 725 adults was selected among participants of the Ministry of Health hypertension control program (Hiperdia). Sixty-five Likert-like items were initially developed guided by the Primary Care Assessment Tool (PCATool), distributed in eight primary care dimensions (health status of confirmed hypertension case, access to diagnosis, access to treatment, adherence, services provided, coordination, focus on family, and community guidance). The process of validation covered consultation with specialists, validation of the Likert-like choices, exploratory factorial analysis, analysis of internal consistency, and confirmatory factorial analysis. Results. Forty-five items that satisfied all criteria were confirmed and used in the final scale. The instrument's validation study revealed high overall internal consistency (Cronbach alpha = 91.5%) and high internal consistency in each of the eight dimensions (> 70%). All reliability and validity indicators show that the evaluation of user satisfaction level with the proposed instrument is valid and reliable. Conclusions. The proposed instrument can be reproduced and used with adult hypertensive individuals receiving primary health care in other regions of Brazil.