Development and validation of the 9-item Patient Satisfaction Questionnaire (PSQ-9) for use in community pharmacy settings

Background Patient satisfaction is a key indicator of healthcare quality and a driver of medication adherence and trust in community pharmacy practice. However, validated instruments that specifically assess patients’ satisfaction with community pharmacists and pharmacies remain scarce. This study aimed to develop and validate the 9-item Patient Satisfaction Questionnaire (PSQ-9), a concise tool tailored to community pharmacy settings, and to identify factors associated with patient satisfaction.Methods A cross-sectional online survey of 501 adults from all Lebanese districts was conducted between February and May 2025. The PSQ-9 was derived from the modified 18-item PSQ using exploratory (EFA) and confirmatory (CFA) factor analyses on two independent subsamples. Psychometric testing included internal consistency, test-retest reliability, construct validity, and multigroup CFA to assess measurement invariance. Multivariable linear regression identified correlates of satisfaction.Results The PSQ-9 demonstrated a two-factor structure, Interpersonal Care and Professional Engagement and Affordability and Informational Assurance, with excellent model fit (CFI = 0.984, RMSEA = 0.056, SRMR = 0.027) and reliability (α = 0.904, ω = 0.910, ICC = 0.729). Measurement invariance was established across gender, health status, and access to care. Higher satisfaction was associated with easier access to healthcare (B = 1.470, P = 0.012), pharmacist counselling from time to time (B = 1.616, P = 0.004) or regularly (B = 1.864, P = 0.008), longer counselling (>10 min; B = 2.441, P = 0.004), higher patient expectations (B = 0.356, P = 0.001) and perceptions (B = 0.110, P = 0.002), and fewer communication barriers (B = –0.235, P = 0.005).Conclusion The PSQ-9 is a valid, reliable, and contextually adapted instrument for assessing patient satisfaction with community pharmacy services. Its brevity and psychometric robustness make it ideal for large-scale surveys and benchmarking, supporting patient-centered and equitable pharmacy practice improvement.