Development and validation of a scale aiming at measuring perceived patient-centered care by professionals
ABSTRACT Objective: Patient-centered care is a concept recently implemented in French hospitals. No tools have been developing to measure patient-centeredness perceived by professional. The aim of the project was to develop and to validate a self-measure scale for healthcare providers. Methods: The project has been conducting from June 2010 to June 2011. A multispecialty working group defined the conceptual framework (brainstorming, formalized consensus method), then built the questionnaire. After the pretest, the tool consisted in 44 items experimented in 35 shifts of 28 organizations. Exploratory and confirmatory psychometric properties were then tested (Principal component analysis, Cronbach' α coefficients, Structural equation modeling). Results: Professional participation rate was 55%. The final solution produced a 16 items questionnaire and 3 dimensions (41,6% of the explained variance): Respect (5 items), Organisation (6 items), Patient and family information (5 items). Cronbach α coefficients were respectively 0,68, 0,83 and 0,68. Conclusion: This first patient-centered care scale developed in the French context had good psychometric properties. The questionnaire will be tested another time next year in order to comfort our results and to explore jointly the patient perceptions of patient-centered care.
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ABSTRACT: Composite measurement scales (CMSs) have contributed to improving the measurement of complex medical phenomena such as physical and psychological functioning or health-related quality of life. However, their use in patient care and research is often limited by their length and excessive respondent burden. In such situations, short instruments should be made available. Efforts to develop short instruments have largely focused on shortening existing instruments. To investigate the methodology currently used in the shortening of CMS, we assessed 42 studies reported in medical, psychological, and educational journals between 1984 and 1994. A number of methodological and statistical considerations important in the CMS shortening procedure were found to have been ignored or neglected by authors developing short forms from existing CMS. Serious flaws appear mainly to result from inadequate conceptualization of the shortening process, and inappropriate use and excess credit given to statistical techniques used to select items to be retained in short forms. When performed, the assessment of measurement properties of the short form was often inappropriate, and cross validation studies were seldom conducted. We propose recommendations for shortening existing CMS, to help authors and investigators develop and choose, respectively, shortened measurement instruments. These recommendations address the preliminary choice of the original CMS to be shortened, and the two successive phases to be considered in the development of short forms: the shortening process itself, where items are selected, and the validation of the shortened CMS, which should be conducted independently using independent subject samples.Journal of Clinical Epidemiology 04/1997; 50(3):247-52. DOI:10.1016/S0895-4356(96)00363-0 · 5.48 Impact Factor
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ABSTRACT: Patient-centered care is widely acknowledged as a core value in family medicine. In this systematic review, we aimed to identify and compare instruments, subscales, or items assessing patients' perceptions of patient-centered care in family medicine. We conducted a systematic literature review using the MEDLINE, Embase, and Cochrane databases covering 1980 through April 2009, with a specific search strategy for each database. The search strategy was supplemented with searching by hand and expert suggestions. We looked for articles meeting all of the following criteria: (1) describing self-administered instruments measuring patient perceptions of patient-centered care; (2) reporting quantitative or psychometric results of development or validation; (3) being relevant to an ambulatory family medicine context. The quality of each article retained was assessed using a modified version of the Standards for Reporting of Diagnostic Accuracy. Instrument' items were mapped to dimensions of a patient-centered care conceptual framework. Of the 3,045 articles identified, 90 were examined in detail, and 26, covering 13 instruments, met our inclusion criteria. Two instruments (5 articles) were dedicated to patient-centered care: the Patient Perception of Patient-Centeredness and the Consultation Care Measure, and 11 instruments (21 articles) included relevant subscales or items. The 2 instruments dedicated to patient-centered care address key dimensions but are visit-based, limiting their applicability for the study of care processes over time, such as chronic illness management. Relevant items from the 11 other instruments provide partial coverage of the concept, but these instruments were not designed to provide a specific assessment of patient-centered care.The Annals of Family Medicine 03/2011; 9(2):155-64. DOI:10.1370/afm.1226 · 4.57 Impact Factor
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ABSTRACT: The paper describes the construction and initial evaluation of the new Tucker-Culturally Sensitive Health Care Inventory (T-CSHCI) Provider Form, which was developed to address the shortcomings of existing similar measures. Two hundred seventeen (217) 3rd and 4th year medical students completed the T-CSHCI-Provider Form. Factor analysis was used to identify non-overlapping items. The final solution produced five factors: patient-centeredness, interpersonal skills, disrespect/disempowerment, competence, and cultural knowledge/responsiveness. The five T-CSHCI-Provider Form factors/subscales proved to be reliable and were associated with related constructs as hypothesized. This study provides initial evidence that the T-CSHCI-Provider Form measures independent dimensions of patient-centered culturally sensitive health care as perceived by medical students. Recommendations for ways in which the T-CSHCI Provider Form can be used to guide culturally sensitive health care training are provided.Journal of Community Health 04/2010; 35(2):198-207. DOI:10.1007/s10900-009-9212-2 · 1.28 Impact Factor