Panouillères M, Anota A, Nguyen T V, Brédart A, Bosset J F, Monnier A, Mercier M, Hardouin J B
EA3181, University of Franche-Comte, Besançon, France,
Qual Life Res. 2014 Sep;23(7):2089-101. doi: 10.1007/s11136-014-0658-z. Epub 2014 Mar 7.
The present study investigates the properties of the French version of the OUT-PATSAT35 questionnaire, which evaluates the outpatients' satisfaction with care in oncology using classical analysis (CTT) and item response theory (IRT).
This cross-sectional multicenter study includes 692 patients who completed the questionnaire at the end of their ambulatory treatment. CTT analyses tested the main psychometric properties (convergent and divergent validity, and internal consistency). IRT analyses were conducted separately for each OUT-PATSAT35 domain (the doctors, the nurses or the radiation therapists and the services/organization) by models from the Rasch family. We examined the fit of the data to the model expectations and tested whether the model assumptions of unidimensionality, monotonicity and local independence were respected.
A total of 605 (87.4%) respondents were analyzed with a mean age of 64 years (range 29-88). Internal consistency for all scales separately and for the three main domains was good (Cronbach's α 0.74-0.98). IRT analyses were performed with the partial credit model. No disordered thresholds of polytomous items were found. Each domain showed high reliability but fitted poorly to the Rasch models. Three items in particular, the item about "promptness" in the doctors' domain and the items about "accessibility" and "environment" in the services/organization domain, presented the highest default of fit. A correct fit of the Rasch model can be obtained by dropping these items. Most of the local dependence concerned items about "information provided" in each domain. A major deviation of unidimensionality was found in the nurses' domain.
CTT showed good psychometric properties of the OUT-PATSAT35. However, the Rasch analysis revealed some misfitting and redundant items. Taking the above problems into consideration, it could be interesting to refine the questionnaire in a future study.
本研究调查了OUT-PATSAT35问卷法语版的特性，该问卷使用经典分析（CTT）和项目反应理论（IRT）评估肿瘤门诊患者对医疗护理的满意度。
这项横断面多中心研究纳入了692例在门诊治疗结束时完成问卷的患者。CTT分析测试了主要的心理测量特性（收敛效度和区分效度以及内部一致性）。IRT分析针对OUT-PATSAT35的每个领域（医生、护士或放射治疗师以及服务/组织）分别采用Rasch家族模型进行。我们检查了数据与模型预期的拟合情况，并测试了模型的单维性、单调性和局部独立性假设是否得到满足。
共分析了605名（87.4%）受访者，平均年龄64岁（范围29 - 88岁）。所有量表单独以及三个主要领域的内部一致性良好（Cronbach's α为0.74 - 0.98）。IRT分析采用部分计分模型进行。未发现多分类项目的无序阈值。每个领域显示出高信度，但与Rasch模型的拟合度较差。特别是医生领域中关于“及时性”的项目以及服务/组织领域中关于“可及性”和“环境”的项目，拟合度最差。剔除这些项目可获得Rasch模型的正确拟合。大多数局部依赖性涉及每个领域中关于“提供的信息”的项目。在护士领域发现了单维性的主要偏差。
CTT显示OUT-PATSAT35具有良好的心理测量特性。然而，Rasch分析揭示了一些拟合不佳和冗余的项目。考虑到上述问题，在未来的研究中对问卷进行完善可能会很有意义。
