Seymour Health Centre, Inc. Vancouver, British Columbia, Canada.
Department of Public Health, Amsterdam University Medical Center, The Netherlands.
Perm J. 2020;24. doi: 10.7812/TPP/19.191. Epub 2020 Apr 21.
Measuring the experiences of patients regarding delivery and receipt of person-oriented primary care is of increasing policy and research interest and is a core component of the Institute for Healthcare Improvement's Quadruple Aim.
To describe the Problem-Oriented Patient Experience-Primary Care (POPE-PC) survey, a novel instrument designed to measure patients' experiences of primary care, and to assess the instrument's psychometric properties.
Psychometric testing was performed using data from a Canadian urgent primary care center, derived from March 2019 to September 2019. Patients automatically received the 9-question survey by email after leaving the clinic. Exploratory factor analysis (EFA) on all questions and the entire dataset was performed using parallel analysis and scree plot for factor extraction. Internal consistency was assessed by calculating Cronbach α. A split-half cross-validation of the ensuing factor structure was conducted. A correlation analysis helped explore associations between the survey's questions.
Results from the initial EFA indicate that the POPE-PC has a conceptually sound 2-factor structure, with good internal consistency. A split-half validation yielded the same findings, reaffirming that the 2-factor model has good psychometric properties. The correlation analysis indicated that the concept of respect is strongly associated with clinical functions related to problem recognition.
Problem recognition, despite being the cornerstone of person-oriented primary care, remains largely overlooked in health services research. The POPE-PC's validity and problem orientation render it potentially useful in rigorously assessing patient experiences of problem-oriented primary care.
The survey's conceptual underpinning and psychometric properties, coupled with its simple and parsimonious design, enable application in primary care settings to provide person-oriented care.
衡量患者对以人为中心的初级保健的体验和接受程度，这无论是在政策还是研究方面都越来越受到关注，也是改善医疗保健协会（Institute for Healthcare Improvement）四重目标的核心组成部分。
描述问题导向的患者初级保健体验（Problem-Oriented Patient Experience-Primary Care，POPE-PC）调查，这是一种新的工具，旨在衡量患者对初级保健的体验，并评估该工具的心理测量特性。
使用加拿大一家紧急初级保健中心 2019 年 3 月至 9 月的数据进行心理测量测试。患者离开诊所后，会自动通过电子邮件收到这个 9 个问题的调查。使用平行分析和谱系图对所有问题和整个数据集进行探索性因素分析（EFA）以提取因子。通过计算 Cronbach α 来评估内部一致性。进行了因子结构的两半交叉验证。相关性分析有助于探索调查问题之间的关联。
初始 EFA 的结果表明，POPE-PC 具有概念上合理的 2 因素结构，具有良好的内部一致性。两半验证得出了相同的发现，再次证实了 2 因素模型具有良好的心理测量特性。相关性分析表明，尊重的概念与与问题识别相关的临床功能密切相关。
尽管问题识别是以人为中心的初级保健的基石，但在卫生服务研究中仍在很大程度上被忽视。POPE-PC 的有效性和问题导向使其在严格评估以人为中心的初级保健的患者体验方面具有潜在的用途。
该调查的概念基础和心理测量特性，加上其简单而简约的设计，使其能够在初级保健环境中应用，以提供以人为中心的护理。
