Dataset Information

Development and psychometric evaluation of a measure to evaluate the quality of integrated care: the Patient Assessment of Integrated Elderly Care.

ABSTRACT:

Background

Novel population-based integrated care services are being developed to adequately serve the growing number of elderly people. Suitable, reliable and valid measurement instruments are needed to evaluate the quality of care delivered.

Objective

To develop a measure to evaluate the quality of integrated care from the perspective of elderly people, the Patient Assessment of Integrated Elderly Care (PAIEC), and then to assess its psychometric properties.

Methods/design

After the Patient Assessment of Chronic Illness Care was adapted to the PAIEC, a cross-sectional postal-survey study was performed among 223 elderly people who received integrated elderly care and support. We assessed the factor structure, internal consistency, known groups and divergent validity using robust nonparametric tests.

Results

Mean age of participants was 83 years (standard deviation 4.7), and 69% was female. The original five-factor model was rejected; a good fit was found for a three-factor model, when excluding the item on patients' satisfaction with care. The PAIEC and its subscales showed good internal consistency (ordinal alphas > 0.90). Known-groups validity was supported regarding number of medications, prevalence of chronic conditions and home care received. No differences were found between groups based on sociodemographic aspects. Divergent validity was supported by low correlations (Spearman's rank correlation coefficients < 0.30) between PAIEC scales and measures of quality of life, complexity of care needs and frailty.

Conclusion

The PAIEC seems to have considerable potential as a reliable and valid measurement instrument that evaluates quality of integrated care and support from the perspective of elderly people.

SUBMITTER: Uittenbroek RJ

PROVIDER: S-EPMC5042070 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:ObjectiveThe primary objective was to translate the Recovering Quality of Life (ReQoL) measures from English to traditional Chinese and assess their psychometric properties in Hong Kong (HK) Chinese population. The secondary objective was to investigate the mental health-related quality of life (HRQoL) of this sample during the coronavirus disease 2019 (COVID-19) pandemic.MethodRecovering Quality of Life was translated to Traditional Chinese adhering to standard guideline recommended by the official distributors. Five hundred members of the general population were successfully recruited to participate in a telephone-based survey. The following psychometric properties of the ReQoL were evaluated: construct, convergent, and known-group validity and internal consistency and test-retest reliability. The item measurement invariance was assessed on the basis of differential item functioning (DIF). Multiple regression analysis was used to assess the relationship between respondents' characteristics and mental HRQoL.ResultsResults of confirmatory factor analysis (CFA) supported a two-factor structure of the ReQoL. The ReQoL showed significant correlations with the other mental health, quality of life, and well-being measures, which indicated a satisfactory convergent validity. Known-group validity confirmed that ReQoL is able to differentiate between people with different mental health status. The (Cronbach's alpha = 0.91 and 0.76 for positive [PF] and negative [NF] factor), and McDonald's omega of 0.89 (PF = 0.94, NF = 0.82) indicated the ReQoL has good reliability as well as test-retest reliability with an intraclass correlation coefficient of 0.75. Four items showed negligible DIF with respect to age. Respondents who were highly educated and without psychological problems reported a high ReQoL score.ConclusionTraditional Chinese ReQoL was shown to be a valid and reliable instrument to assess the recovery-focused quality of life in HK general population. Future studies are needed to appraise its psychometric properties in local people experiencing mental disorders.

Project description:BACKGROUND:Successfully implementing eMental health (eMH) interventions in routine mental health care constitutes a major challenge. Reliable instruments to assess implementation progress are essential. The Normalization MeAsure Development (NoMAD) study developed a brief self-report questionnaire that could be helpful in measuring implementation progress. Based on the Normalization Process Theory, this instrument focuses on 4 generative mechanisms involved in implementation processes: coherence, cognitive participation, collective action, and reflexive monitoring. OBJECTIVE:The aim of this study was to translate the NoMAD questionnaire to Dutch and to confirm the factor structure in Dutch mental health care settings. METHODS:Dutch mental health care professionals involved in eMH implementation were invited to complete the translated NoMAD questionnaire. Confirmatory factor analysis (CFA) was conducted to verify interpretability of scale scores for 3 models: (1) the theoretical 4-factor structure, (2) a unidimensional model, and (3) a hierarchical model. Potential improvements were explored, and correlated scale scores with 3 control questions were used to assess convergent validity. RESULTS:A total of 262 professionals from mental health care settings in the Netherlands completed the questionnaire (female: 81.7%; mean age: 45 [SD=11]). The internal consistency of the 20-item questionnaire was acceptable (.62≤alpha≤.85). The theorized 4-factor model fitted the data slightly better in the CFA than the hierarchical model (Comparative Fit Index=0.90, Tucker Lewis Index=0.88, Root Mean Square Error of Approximation=0.10, Standardized Root Mean Square Residual=0.12, χ22=22.5, P≤.05). However, the difference is small and possibly not outweighing the practical relevance of a total score and subscale scores combined in one hierarchical model. One item was identified as weak (λCA.2=0.10). A moderate-to-strong convergent validity with 3 control questions was found for the Collective Participation scale (.47≤r≤.54, P≤.05). CONCLUSIONS:NoMAD's theoretical factor structure was confirmed in Dutch mental health settings to acceptable standards but with room for improvement. The hierarchical model might prove useful in increasing the practical utility of the NoMAD questionnaire by combining a total score with information on the 4 generative mechanisms. Future research should assess the predictive value and responsiveness over time and elucidate the conceptual interpretability of NoMAD in eMH implementation practices.

Project description:BackgroundThe experience sampling method (ESM) holds advantages over traditional retrospective questionnaires including a high ecological validity, no recall bias, the ability to assess fluctuation of symptoms, and the ability to analyze the temporal relationship between variables.ObjectiveThis study aimed to evaluate the psychometric properties of an endometriosis-specific ESM tool.MethodsThis is a short-term follow-up prospective study, including patients with premenopausal endometriosis aged ≥18 years who reported dysmenorrhea, chronic pelvic pain, or dyspareunia between December 2019 and November 2020. An ESM-based questionnaire was sent out by a smartphone application 10 times a day during 1 week on randomly chosen moments. Additionally, patients completed questionnaires concerning demographics, end-of-day pain scores, and end-of-week symptom scores. The psychometric evaluation included compliance, concurrent validity, and internal consistency.ResultsTwenty-eight patients with endometriosis completed the study. Compliance for answering the ESM questions was as high as 52%. End-of-week pain scores were higher than ESM mean scores and showed peak reporting. ESM scores showed strong concurrent validity when compared with symptoms scored by the Gastrointestinal Symptom Rating Scale-Irritable Bowel Syndrome, 7-item Generalized Anxiety Disorders Scale, 9-question Patient Health Questionnaire, and the majority of questions of the 30-item Endometriosis Health Profile. Cronbach α coefficients demonstrated a good internal consistency for abdominal symptoms, general somatic symptoms, and positive affect, and an excellent internal consistency for negative affect.ConclusionsThis study supports the validity and reliability of a newly developed electronic instrument for the measurement of symptoms in women with endometriosis, based on momentary assessments. This ESM patient-reported outcome measure has the advantage of providing a more detailed view on individual symptom patterns and offers the possibility for patients to have insight in their symptomatology, leading to more individualized treatment strategies that can improve the quality of life of women with endometriosis.

Project description:ObjectiveTo assess the psychometric properties and construct validity of a survey of primary care providers' (PCPs') experience of specialty care coordination, which is a counterpart to our existing survey ("CSC-Specialist") that measures specialists' experience of specialty care coordination.Data sourcesWe surveyed PCPs from Veterans Health Administration medical centers and community-based outpatient clinics nationwide (N = 1576) in April 2018.Study designWe developed candidate items through literature review, existing surveys, PCP interviews, and expert opinion. We used exploratory and confirmatory factor analysis to develop scales and multivariable linear regression to determine their association with PCPs' overall experience of coordination.Data collectionThe online survey included 23 candidate scale items about specialty care coordination and a single item asking respondents to rate their overall experience of specialty care coordination on a 0-10 scale. All VA PCPs were eligible. We sent survey invitations to PCPs following local Section Chiefs' email introduction (N = 926) and by directly emailing two random samples (N = 400 and N = 6653), overall response rate across the three nonoverlapping samples = 24 percent.Principal findingsAnalyses identified 20 items forming 6 scales with strong psychometric properties and predictive power for overall coordination. Two scales are identical to CSC-Specialist scales: "Communication" (k = 3, α = 0.87) and "Data Transfer" (k = 2, α = 0.92); one is similar: "Relationships and Collaboration" (k = 6, α = 0.90). The three remaining scales address the PCP's unique perspective: "Role Clarity" (k = 3, α = 0.85), "Role Agreement" (k = 3, α = 0.75), and "Making Referrals" (k = 3, α = 0.75). The six scales together explained 67 percent of the variance in PCPs' overall coordination experience with specialists.ConclusionsThe Coordination of Specialty Care-Primary Care Provider Survey (CSC-PCP) is a novel 20-item survey that can be used in quality improvement or health services research, alone or in combination with the CSC-Specialist, to evaluate coordination of care as experienced by either or both participants.