Public Health Foundation, Bangladesh, Dhaka, Bangladesh.
Department of Media Studies and Journalism, University of Liberal Arts Bangladesh, Dhaka, Bangladesh.
BMC Health Serv Res. 2022 Aug 15;22(1):1040. doi: 10.1186/s12913-022-08413-4.
Responsiveness of Physicians (ROP) is defined as the social actions by physicians aimed at meeting the legitimate expectations of healthcare users. Even though patients' expectations regarding ROP have increased during the COVID-19 pandemic, the psychometrically-validated ROP-Scale is difficult to apply in hospital settings. The goal of this study is to validate the existing ROP-Scale to measure the responsiveness of hospital physicians during the ongoing COVID-19 pandemic in Bangladesh.
We conducted a cross-sectional phone survey involving 213 COVID-19 hospital patients, randomly selected from the government database. We applied the Delphi method for content validity, exploratory and confirmatory factor analyses for construct validity, Cronbach's alpha and corrected item-total correlation for internal consistency reliability, and Pearson's correlation between the scale and overall patient satisfaction for concurrent validity.
After removing survey items based on data sufficiency, collinearity, factor loading derived through exploratory factor analysis, and internal consistency, the final version of the COVID-19 ROP-Scale consisted of 7 items, grouped under Informativeness, Trustworthiness and Courteousness domains. The confirmatory factor analysis supported the three domains with acceptable model fit [Root mean squared error of approximation (RMSEA) = 0.028, Comparative fit index (CFI) = 0.997, Tucker-Lewis index (TLI) = 0.994)]. The corrected item-total correlation ranged between 0.45 and 0.71. Concurrent validity was ascertained by the high correlation (0.84) between patient satisfaction and the COVID-19 ROP-Scale. Based on the mean domain score, the highest- and the lowest-scoring responsiveness domains were 'Trustworthiness' (7.85) and 'Informativeness' (7.28), respectively, whereas the highest- and the lowest-scoring items were 'Not being involved in illegal activities' (7.97), and 'Service-oriented, not business-like attitude' (6.63), respectively.
The 7-item COVID-19 ROP-Scale was demonstrated to be feasible, valid, and internally consistent. Therefore, its application can help amend past mistakes in health service provision and improve care for the hospitalised COVID-19 patients or other patients suffering from similar conditions. This study can contribute to the national decision-making regarding hospital care, open up further avenues in the health policy and system research, and eventually improve the quality of care provided to Bangladeshi patients seeking hospital services. Moreover, findings yielded by this study can be incorporated into doctors' medical education and in-service training.
医生反应性（ROP）被定义为医生为满足医疗保健使用者的合法期望而采取的社会行为。尽管在 COVID-19 大流行期间，患者对 ROP 的期望有所增加，但经过心理测量验证的 ROP 量表在医院环境中难以应用。本研究的目的是验证现有的 ROP 量表，以衡量孟加拉国 COVID-19 大流行期间医院医生的反应性。
我们进行了一项横断面电话调查，共涉及 213 名 COVID-19 住院患者，这些患者是从政府数据库中随机选择的。我们应用德尔菲法进行内容效度、探索性和验证性因子分析进行结构效度、克朗巴赫的 alpha 和校正项目总分相关性进行内部一致性可靠性、以及量表与整体患者满意度之间的皮尔逊相关性进行同时效度。
根据数据充足性、共线性、通过探索性因子分析得出的因子负荷以及内部一致性，删除调查项目后，最终版本的 COVID-19 ROP 量表由 7 个项目组成，分为信息性、值得信赖和礼貌性三个领域。验证性因子分析支持三个领域的可接受模型拟合[近似均方误差（RMSEA）=0.028、比较拟合指数（CFI）=0.997、塔克-刘易斯指数（TLI）=0.994]。校正项目总分相关性在 0.45 到 0.71 之间。通过患者满意度与 COVID-19 ROP 量表之间的高相关性（0.84）确定了同时效度。根据平均领域得分，反应性最高和最低的领域分别是“值得信赖”（7.85）和“信息性”（7.28），而得分最高和最低的项目分别是“不参与非法活动”（7.97）和“以服务为导向，不商业化态度”（6.63）。
7 项 COVID-19 ROP 量表具有可行性、有效性和内部一致性。因此，其应用可以帮助纠正过去在卫生服务提供方面的错误，并改善对住院 COVID-19 患者或其他患有类似疾病的患者的护理。本研究可以为国家的医院护理决策做出贡献，为卫生政策和系统研究开辟新的途径，并最终提高寻求医院服务的孟加拉国患者的护理质量。此外，本研究的结果可以纳入医生的医学教育和在职培训。
