Department of Family & Community Medicine, University of California, San Francisco, CA, United States; Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, CA, United States; Department of Epidemiology & Biostatistics, University of California, San Francisco, CA, United States.
Department of Family & Community Medicine, University of California, San Francisco, CA, United States.
Contraception. 2021 May;103(5):310-315. doi: 10.1016/j.contraception.2021.01.008. Epub 2021 Jan 27.
Person-centeredness is a critical component of quality in family planning. We previously validated an 11-item Interpersonal Quality of Family Planning (IQFP) scale. We sought to create a parsimonious version of the scale in preparation for testing its appropriateness as a patient-reported outcome performance measure.
To explore clarity and importance of each of the 11 items, we conducted English and Spanish cognitive interviews with patients who received contraceptive counseling (n = 33) at 3 publicly funded California clinics. We triangulated these results with psychometric analysis of previously collected IQFP data (n = 1097) to assess validity and reliability of selected item combinations.
The 11-item IQFP scale was reduced to a 4-item scale (the Person-Centered Contraceptive Counseling scale, or PCCC) that includes items evaluating provider performance regarding respect for patients, information provision, and eliciting and honoring patient preferences for birth control. Interview participants deemed the items included in the 4-item PCCC important and clear in both English and Spanish versions of the instrument. The 4-item PCCC retained the 11-item IQFP's psychometric properties, including internal consistency (Cronbach's alpha = 0.92 vs 0.97 for the PCCC and IQFP, respectively) and a consistent single factor analysis solution (factor loadings = 0.86-0.92 and 0.81-0.91). The 4-item PCCC additionally retained the construct and predictive validity of the IQFP.
The 4-item PCCC is a valid and reliable as a measure of person-centered contraceptive counseling that reflects patients' perspectives on contraceptive counseling.
Person-centered measures such as the 4-item PCCC can help inform efforts to improve health care quality. Future work will investigate the validity and reliability of the 4-item PCCC as a performance measure to determine the appropriateness of its use in the quality improvement context.
以人为中心是计划生育质量的关键组成部分。我们之前验证了一个包含 11 个项目的计划生育人际质量（IQFP）量表。我们试图创建一个简化版本的量表，为测试其作为患者报告的结果衡量标准的适当性做准备。
为了探索这 11 个项目的每一个的清晰度和重要性，我们对在加利福尼亚州 3 家公共资助的诊所接受避孕咨询的患者（n=33）进行了英语和西班牙语认知访谈。我们将这些结果与之前收集的 IQFP 数据（n=1097）的心理测量分析相结合，以评估选定项目组合的有效性和可靠性。
11 项 IQFP 量表被简化为 4 项量表（以人为中心的避孕咨询量表，或 PCCC），包括评估提供者在尊重患者、提供信息、引出并尊重患者对避孕的偏好方面的表现的项目。接受访谈的参与者认为，在该工具的英语和西班牙语版本中，包含在 4 项 PCCC 中的项目是重要且清晰的。4 项 PCCC 保留了 11 项 IQFP 的心理测量特性，包括内部一致性（Cronbach 的 alpha 值分别为 0.92 和 0.97）和一致的单一因素分析解决方案（因子负荷为 0.86-0.92 和 0.81-0.91）。4 项 PCCC 还保留了 IQFP 的构念和预测有效性。
4 项 PCCC 是一种有效的、可靠的、以人为中心的避孕咨询衡量标准，反映了患者对避孕咨询的看法。
以人为中心的衡量标准，如 4 项 PCCC，可以帮助为改善医疗质量的努力提供信息。未来的工作将调查 4 项 PCCC 作为绩效衡量标准的有效性和可靠性，以确定其在质量改进背景下使用的适当性。
