Promoting Excellence : Satisfaction With Care Questionnaire

Satisfaction With Care Questionnaire. This tool was adapted from existing surveys and used by Cardinal Glennon. Adaptations were based on content provided by focus group subjects.

This is a questionnaire used to assess the experience of the patient and/or family with respect to end of life care in both anticipated and sudden deaths.

Evaluation Tools – Satisfaction/Perception of Care

SSM Cardinal Glennon Children’s Hospital
1465 South Grand Boulevard
St. Louis, MO 63104

Mary Ann Collins, MHA
[email protected]

How the grantee used this instrument:
This tool is given to the caregiver(s) both before and after the child’s death (if possible). If the death is anticipated, the tool is administered every 3 months by phone or in-person. If the death was sudden the tool is administered face to face.

pediatrics, caregiver interview, caregiver perception of care, afterdeath interview, family experience, caregiver experience, family satisfaction, satisfaction survey

To use this tool:
You may print and copy this tool for your own use from this site. Please credit source.

Kaye Norris, PhD (personal communication). Dr. Joan Teno’s Web site, Teno JM. Afterdeath bereaved family interview. Retrieved May 19, 1999 from the Brown University, Center for Gerontology & Health Care Research Web site: Bredart A, Razavi N, Delvaux N et al. A Comprehensive Assessment of Satisfaction with Care for cancer patients. Support Care Cancer 6: 518-523, 1998. Bredart A, Razavi D, Robertson et al. A Comprehensive Assessment of Satisfaction with Care: Preliminary psychometric analysis in an oncology hospital. Annals of Oncology 10: 839-846, 1999.

To view this tool:
To view the tool in your browser left-click on the link below or to download to your computer right-click on the link.
pdf PDF 340 KB / 3 pages

Posted June 30, 2003

SSM Cardinal Glennon Children's Hospital overview page

# GLEN12, type:satisfaction/perception_care

Promoting Excellence in End-of-Life Care was a national program of the Robert Wood Johnson Foundation dedicated to long-term changes in health care institutions to substantially improve care for dying persons and their families. Visit for more resources.

Promoting Excellence logo and link to home page