Dataset Information

Elderly patients' (?65 years) experiences associated with discharge; Development, validity and reliability of the Discharge Care Experiences Survey.

ABSTRACT:

Background

A review of the literature reveals a lack of validated instruments that particularly measure quality in the hospital discharge process. This study aims to develop and validate a survey instrument feasible for measuring quality (?65 years) related to the discharge process based on elderly patients' experiences.

Methods

Construction of the Discharge Care Patient Experience Survey (DICARES) was based on 16 items identified by literature reviews. Intraclass correlation for test-retest was applied to assess consistency of the survey. Explorative factors analysis was applied to identify and validate the factor structures of the DICARES. Cronbach's ? was used to assess internal reliability. To evaluate the external validity of the final DICARES questionnaire the patients' scores were correlated with scores obtained from the three other questionnaires; the Nordic Patient Experiences Questionnaire, the 12-Item Short-Form Health Survey and Subjective Health Complaints. The DICARES association with readmissions was examined.

Results

A total of 270 patients responded (64.4%). The mean age of participants was 77.1 years and 57.8% were men. The exploratory factor analysis resulted in a 10-item instrument consisting of three factors explaining 63.5% of the total variance. The Cronbach's ? were satisfactory (?70). Overall intraclass correlation was 0.76. A moderate Spearman correlation (rho = 0.54, p <0.01) was found between the total mean DICARES score and total mean score of the Nordic Patient Experiences Questionnaire. The total mean DICARES score was inversely associated with the quality indicator based on readmissions (OR 0.62, CI 95: 0.41-0.95, p = 0.028).

Conclusion

We have developed a 10-item questionnaire consisting of three factors which may be a feasible instrument for measuring quality of the discharge process in elderly patients. Further testing in a wider population should be carried out before implementation in health care settings.

SUBMITTER: Boge RM

PROVIDER: S-EPMC6221326 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Elderly patients' (≥65 years) experiences associated with discharge; Development, validity and reliability of the Discharge Care Experiences Survey.

Boge Ranveig Marie RM Haugen Arvid Steinar AS Nilsen Roy Miodini RM Harthug Stig S

PloS one 20181107 11

<h4>Background</h4>A review of the literature reveals a lack of validated instruments that particularly measure quality in the hospital discharge process. This study aims to develop and validate a survey instrument feasible for measuring quality (≥65 years) related to the discharge process based on elderly patients' experiences.<h4>Methods</h4>Construction of the Discharge Care Patient Experience Survey (DICARES) was based on 16 items identified by literature reviews. Intraclass correlation for ...[more]

PMID: 30403738

Similar Datasets

Project description:BACKGROUND:The Discharge Care Experiences Survey (DICARES) was previously developed to measure quality of discharge care in elderly patients (≥ 65 years). The objective of this study was to test the factorial validity of responses of the DICARES, and to investigate its association with existing quality indicators. METHODS:We conducted a cross-sectional study at two hospitals in Bergen, Western Norway. A survey, including DICARES, was sent by postal mail to 1,418 patients 30 days after discharge from hospital. To test the previously identified three-factor structure of the DICARES we applied a first order confirmatory factor analysis with corresponding fit indices and reliability measures. Spearman's correlation coefficients, and linear regression, was used to investigate the association of DICARES scores with the quality indicators Nordic Patient Experiences Questionnaire and emergency readmission within 30 days. RESULTS:A total of 493 (35%) patients completed the survey. The mean age of the respondents was 79 years (SD = 8) and 52% were women. The confirmatory factor analysis showed acceptable fit. Cronbach's α between items within factors was 0.82 (Coping after discharge), 0.71 (Adherence to treatment), and 0.66 (Participation in discharge planning). DICARES was moderately correlated with the Nordic Patient Experiences Questionnaire (rho = 0.49, P < 0.001). DICARES overall score was higher in patients with no readmissions compared to those who were emergency readmitted within 30 days (P < 0.001), indicating that more positive experiences were associated with fewer readmissions. CONCLUSIONS:DICARES appears to be a feasible instrument for measuring quality of discharge care in elderly patients (≥ 65 years). This brief questionnaire seems to be sensitive with regard to readmission, and independent of comorbidity. Further studies of patients' experiences are warranted to identify elements that impact on discharge care in other patient groups.

Project description:ContextSelf-report questionnaires are an important method of evaluating lifespan health, exercise, and health-related quality of life (HRQL) outcomes among elite, competitive athletes. Few instruments, however, have undergone formal characterization of their psychometric properties within this population.ObjectiveTo evaluate the validity and reliability of a novel health and exercise questionnaire, the Trojan Lifetime Champions (TLC) Health Survey.DesignDescriptive laboratory study.SettingA large National Collegiate Athletic Association Division I university.Patients or other participantsA total of 63 university alumni (age range, 24 to 84 years), including former varsity collegiate athletes and a control group of nonathletes.Intervention(s)Participants completed the TLC Health Survey twice at a mean interval of 23 days with randomization to the paper or electronic version of the instrument.Main outcome measure(s)Content validity, feasibility of administration, test-retest reliability, parallel-form reliability between paper and electronic forms, and estimates of systematic and typical error versus differences of clinical interest were assessed across a broad range of health, exercise, and HRQL measures.ResultsCorrelation coefficients, including intraclass correlation coefficients (ICCs) for continuous variables and κ agreement statistics for ordinal variables, for test-retest reliability averaged 0.86, 0.90, 0.80, and 0.74 for HRQL, lifetime health, recent health, and exercise variables, respectively. Correlation coefficients, again ICCs and κ, for parallel-form reliability (ie, equivalence) between paper and electronic versions averaged 0.90, 0.85, 0.85, and 0.81 for HRQL, lifetime health, recent health, and exercise variables, respectively. Typical measurement error was less than the a priori thresholds of clinical interest, and we found minimal evidence of systematic test-retest error. We found strong evidence of content validity, convergent construct validity with the Short-Form 12 Version 2 HRQL instrument, and feasibility of administration in an elite, competitive athletic population.ConclusionsThese data suggest that the TLC Health Survey is a valid and reliable instrument for assessing lifetime and recent health, exercise, and HRQL, among elite competitive athletes. Generalizability of the instrument may be enhanced by additional, larger-scale studies in diverse populations.

Project description:ObjectivesPatient experience questionnaires have been criticised owing to the lack of supporting psychometric evidence. The objective of this study was to describe the development and psychometric evaluation of the Cancer Patient Experiences Questionnaire (CPEQ) in Norway.DesignQuestionnaire development was based on a literature review of existing questionnaires, patient interviews, expert-group consultations, pretesting of questionnaire items and a national survey. Psychometric evaluation included exploratory and confirmatory factor analysis, and tests of internal consistency reliability and test-retest reliability.SettingData were collected using a postal survey of cancer patients attending 54 hospitals in all 4 health regions. The subjects were 14 227 adult cancer patients who had attended an outpatient clinic or who had been discharged from an inpatient ward. Patients with all types of cancer were included. Data quality, internal consistency reliability and construct validity were assessed.ResultsOf the 13 846 patients who received the CPEQ, 7212 (52%) responded. Exploratory factor analysis identified six scales of outpatient experiences relating to nurse contact, doctor contact, information, organisation, patient safety and contact with next of kin, and seven scales of inpatient experiences, with the addition of hospital standard to the aforementioned scales. All but two of the scales met the criterion of 0.70 for Cronbach's ? testing, and test-retest correlations ranged from 0.57 to 0.85. Confirmatory factor analysis supported the interpretation of six and seven scales for outpatients and inpatients, respectively. Statistically significant associations based on explicit hypotheses provided evidence for the construct validity of the scales. One additional scale measuring the hospital level was identified (?=0.85).ConclusionsThe CPEQ is a self-report instrument that includes the most important aspects of patient experiences with cancer care at hospitals. The instrument was tested following a national survey in Norway; good evidence is provided herein for the internal consistency reliability, test-retest reliability and construct validity.

Project description:OBJECTIVES:The aim of this study was to test the reliability and validity of a new questionnaire for measuring patient experiences with general practitioners (PEQ-GP) following a national survey. SETTING:Postal survey among patients on any of 500 GPs patient lists in Norway. GPs were stratified by practice size and geographical criteria. PARTICIPANTS:4964 patients who had at least one consultation with their regular GP in the foregoing 12 months were included in the study. The patients were randomly selected after the selection of GPs. 2377 patients (49%) responded to the survey. PRIMARY AND SECONDARY OUTCOME MEASURES:The items were assessed for missing data and ceiling effects. Factor structure was assessed using exploratory factor analyses. Reliability was tested with item-total correlation, Cronbach's alpha and test-retest correlations. Item discriminant validity was tested by correlating items with all scales. Construct validity was assessed through associations of scale scores with health status, the patients' general satisfaction with the services, whether the patient had been incorrectly treated by the GP and whether the patient would recommend the GP to others. RESULTS:Item missing varied from 1.0% to 3.1%, while ceiling effects varied from 16.1% to 45.9%. The factor analyses identified three factors. Reliability statistics for scales based on these three factors, and two theoretically derived scales, showed item-total correlations ranging from 0.63 to 0.85 and Cronbach's alpha values from 0.77 to 0.93. Test-retest correlation for the five scales varied from 0.72 to 0.88. All scales had the expected association with other variables. CONCLUSIONS:The PEQ-GP has good evidence for data quality, internal consistency and construct validity. The PEQ-GP is recommended for use in local, regional and national surveys in Norway, but further studies are needed to assess the instrument's ability to detect differences over time and between different GPs.