Department Social and Behavioural Research, ICMR-National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India.
DTO, National Tuberculosis Elimination Program (NTEP), Greater Chennai Corporation, Chennai, Tamil Nadu, India.
BMJ Open Qual. 2022 Jul;11(3). doi: 10.1136/bmjoq-2021-001787.
At present, there are no validated quantitative scales available to measure patient-centred quality of care in health facilities providing services for tuberculosis (TB) patients in India and low-income and middle-income countries.
Initial themes and items reflective of TB patient's perceived quality of care were developed using qualitative interviews. Content adequacy of the items were ascertained through Content validity Index (CVI) and content validity ratio (CVR). Pilot testing of the questionnaire for assessing validity and reliability was undertaken among 714 patients with TB. Sampling adequacy and sphericity were tested by Kaiser-Meyer-Olkin and Bartlett's test, respectively. Exploratory and confirmatory factor analysis was undertaken to test validity. Cronbach's α and test-retest scores were used to test reliability.
A 32-item tool measuring patient-perceived quality of TB distributed across five domains was developed initially based on a CVI and CVR cut-off score of 0.78 and cognitive interviews with patients with TB. Bartlett's test results showed a strong significance f (χ=3756 and p<0.001) and Kaiser-Meyer-Olkin was measured to be 0.698 highlighting data adequacy and correlation between the variables. Exploratory factor analysis with varimax rotation extracted 4 factors related to 14 items with Eigen values >1 which accounted for 60.9% of the total variance of items. Correlation (z-value >1.96) between items and factors was highly significant and Cronbach's α was acceptable for the global scale (0.76) for the four factors. Intraclass correlation coefficient and the test retest scores for four factors were (<0.001) significant.
We validated a measurement tool for patient-perceived quality of care for TB (PPQCTB) which measured the patient's satisfaction with healthcare provider and services. PPQCTB tool could enrich quality of care evaluation frameworks for TB health services in India.
目前，在为印度和中低收入国家的结核病（TB）患者提供服务的卫生机构中，还没有经过验证的定量量表来衡量以患者为中心的医疗质量。
使用定性访谈开发了最初反映 TB 患者感知医疗质量的主题和项目。通过内容有效性指数（CVI）和内容有效性比（CVR）确定项目的内容充分性。对 714 名结核病患者进行了评估问卷的信度和效度的预试验。分别通过 Kaiser-Meyer-Olkin 和 Bartlett 检验测试样本充足性和球形度。进行探索性和验证性因子分析以检验有效性。使用 Cronbach's α 和测试-重测分数来检验可靠性。
最初基于 CVI 和 CVR 截断值为 0.78 和与结核病患者的认知访谈，开发了一个衡量患者感知结核病质量的 32 项工具，分布在五个领域。Bartlett 检验结果显示具有很强的意义 f（χ=3756，p<0.001），Kaiser-Meyer-Olkin 测量值为 0.698，突出了数据充足性和变量之间的相关性。使用最大方差旋转进行探索性因子分析提取了 4 个与 14 个特征值>1 的项目相关的因子，这些因子占项目总方差的 60.9%。项目与因子之间的相关性（z 值>1.96）高度显著，四个因子的 Cronbach's α 为 0.76，可接受。4 个因子的组内相关系数和重测分数均为（<0.001）显著。
我们验证了一种用于结核病患者感知医疗质量（PPQCTB）的测量工具，该工具衡量了患者对医疗保健提供者和服务的满意度。PPQCTB 工具可以丰富印度结核病卫生服务的医疗质量评估框架。
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