Nyköping Hospital, Sörmland County Council, Nyköping, Sweden.
Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
Health Expect. 2023 Jun;26(3):1137-1148. doi: 10.1111/hex.13728. Epub 2023 Feb 16.
Hospitalization due to cardiac conditions is increasing worldwide, and follow-up after hospitalization usually occurs in a different healthcare setting than the one providing treatment during hospitalization. This leads to a risk of fragmented care and increases the need for coordination and continuity of care after hospitalization. Furthermore, international reports highlight the importance of improving continuity of care and state that it is an essential indicator of the quality of care. Patients' perceptions of continuity of care can be evaluated using the Patient Continuity of Care Questionnaire (PCCQ). However, the original version is extensive and may prove burdensome to complete; therefore, we aimed to develop and evaluate a short version of the PCCQ.
This was a psychometric validation study. Content validity was evaluated among user groups, including patients (n = 7), healthcare personnel (n = 15), and researchers (n = 7). Based on the results of the content validity and conceptual discussions among the authors, 12 items were included in the short version. Data from patients were collected using a consecutive sampling procedure involving patients 6 weeks after hospitalization due to cardiac conditions. Rasch analysis was used to evaluate the psychometric properties of the short version of the PCCQ.
A total of 1000 patients were included [mean age 72 (SD = 10), 66% males]. The PCCQ-12 presented a satisfactory overall model fit and a person separation index of 0.79 (Cronbach's α: .91, ordinal α: .94). However, three items presented individual item misfits. No evidence of multidimensionality was found, meaning that a total score can be calculated. A total of four items presented evidence of response dependence but, according to the analysis, this did not seem to affect the measurement properties or reliability of the PCCQ-12. We found that the first two response options were disordered in all items. However, the reliability remained the same when these response options were amended. In future research, the benefits of the four response options could be evaluated.
The PCCQ-12 has sound psychometric properties and is ready to be used in clinical and research settings to measure patients' perceptions of continuity of care after hospitalization.
Patients, healthcare personnel and researchers were involved in the study because they were invited to select items relevant to the short version of the questionnaire.
由于心脏疾病而住院的人数在全球范围内不断增加，而住院后的随访通常发生在与住院期间提供治疗的医疗机构不同的医疗机构中。这导致了医疗服务碎片化的风险，并增加了住院后医疗服务协调和连续性的需求。此外，国际报告强调了提高医疗服务连续性的重要性，并指出这是医疗服务质量的一个重要指标。患者对医疗服务连续性的看法可以通过使用患者医疗服务连续性问卷（PCCQ）进行评估。然而，原始版本较为冗长，可能会给患者带来负担，因此，我们旨在开发和评估 PCCQ 的简短版本。
这是一项心理测量验证研究。内容有效性在用户群体中进行了评估，包括患者（n=7）、医疗保健人员（n=15）和研究人员（n=7）。根据内容有效性的结果和作者之间的概念讨论，简短版本中包含了 12 个项目。通过连续抽样程序，在患者住院后 6 周时收集患者的数据。使用 Rasch 分析评估 PCCQ 简短版本的心理测量特性。
共纳入 1000 名患者[平均年龄 72（SD=10）岁，66%为男性]。PCCQ-12 总体模型拟合良好，个人分离指数为 0.79（Cronbach's α：.91，有序 α：.94）。然而，有三个项目存在个别项目不拟合的情况。没有发现多维性的证据，这意味着可以计算总分。共有四个项目存在反应依赖性的证据，但根据分析，这似乎并没有影响 PCCQ-12 的测量特性或可靠性。我们发现，所有项目的前两个反应选项都存在紊乱。然而，当修改这些反应选项时，可靠性保持不变。在未来的研究中，可以评估这四个反应选项的优势。
PCCQ-12 具有良好的心理测量特性，可在临床和研究环境中使用，以衡量患者对住院后医疗服务连续性的看法。
患者、医疗保健人员和研究人员参与了这项研究，因为他们被邀请选择与问卷简短版本相关的项目。
