Research Directorate, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
Department of Pharmaceutics & Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
PLoS One. 2024 May 15;19(5):e0300815. doi: 10.1371/journal.pone.0300815. eCollection 2024.
Accessing healthcare services is a multifaceted phenomenon involving various elements, encompassing the demand, identification, reach, and utilization of healthcare needs. The literature offers methods for capturing patients' perceptions of healthcare access. However, to accurately measure patient perceptions, it is imperative to ensure the validity and reliability of such instruments by designing and implementing localized language versions.
The primary aim of this study was to validate the Amharic version of the perceived access to health-care services among patients diagnosed with cervical cancer in Ethiopia.
A cross-sectional study was conducted among cervical cancer patients at oncology centers in Addis Ababa, Ethiopia. A consecutive sampling approach was used and data collection took place from January 1 to March 30, 2023. Following initial validation and pretesting, a KoboCollect mobile phone application was employed for data collection. Subsequently, the collected data underwent cleaning in Microsoft Excel and analysis through Amos software v.26 and R programming. Various validity and reliability tests, such as content validity, convergent validity, face validity, divergent validity, known-group validity, and reliability tests, were executed. A second-order confirmatory factor analysis was developed to calculate incremental model fit indices, including CFI and TLI, along with absolute measures, namely SRMR and RMSEA.
A total of 308 participants were involved in the study, with 202 (65.6%) being patients referred from outside Addis Ababa. The initial evaluation of content validity by expert panels indicated that all criteria were met, with a CVR range of 0.5 to 1, I-CVI values ranging from 0.75 to 1, an S-CVI value of 0.91, and face validity values ranging from 2.4 to 4.8. The internal consistency of items within the final constructs varied from 0.76 to 0.93. Convergent, known-group, and most divergent validity tests fell within acceptable fit ranges. Common incremental fit measures for CFI and TLI were achieved with corresponding values of 0.95 and 0.94, respectively. The absolute fit measures of SRMR and RMSEA were 0.04 and 0.07, indicating good and moderate fit, respectively.
The study indicated a high internal consistency and validity of items with good fit to the data, suggesting potential accuracy of the domains. A five-domain structure was developed which enables adequate assessment of perceived access to health-care services of patients with cervical cancer in Ethiopia. We suggest that the tool can be utilized in other patient populations with a consideration of additional constructs, such as geographic accessibility.
获取医疗服务是一个多方面的现象，涉及到各种要素，包括医疗需求的需求、识别、可达性和利用。文献提供了捕捉患者对医疗服务可及性看法的方法。然而，为了准确衡量患者的看法，必须通过设计和实施本地化语言版本来确保这些工具的有效性和可靠性。
本研究的主要目的是验证埃塞俄比亚宫颈癌患者的阿法尔语版感知医疗服务可及性量表。
这是一项在埃塞俄比亚亚的斯亚贝巴肿瘤中心进行的宫颈癌患者的横断面研究。采用连续抽样方法，数据收集时间为 2023 年 1 月 1 日至 3 月 30 日。在初步验证和预测试后，使用 KoboCollect 移动电话应用程序进行数据收集。随后，在 Microsoft Excel 中对收集到的数据进行清理，并通过 Amos 软件 v.26 和 R 编程进行分析。进行了各种有效性和可靠性测试，如内容有效性、收敛有效性、表面有效性、发散有效性、已知组有效性和可靠性测试。开发了二阶验证性因子分析来计算增量模型拟合指数，包括 CFI 和 TLI，以及绝对指标，即 SRMR 和 RMSEA。
共有 308 名参与者参与了这项研究，其中 202 名（65.6%）是从亚的斯亚贝巴以外转诊的患者。由专家小组进行的初步内容有效性评估表明，所有标准均得到满足，CVR 范围为 0.5 至 1，I-CVI 值范围为 0.75 至 1，S-CVI 值为 0.91，表面有效性值范围为 2.4 至 4.8。最终结构内项目的内部一致性从 0.76 到 0.93 不等。收敛性、已知组和大多数发散性有效性测试均处于可接受的拟合范围内。CFI 和 TLI 的常见增量拟合指标分别为 0.95 和 0.94。SRMR 和 RMSEA 的绝对拟合指标分别为 0.04 和 0.07，表明拟合良好和适中。
研究表明，项目的内部一致性和有效性较高，与数据拟合良好，表明各领域的潜在准确性。开发了一个五领域结构，能够充分评估埃塞俄比亚宫颈癌患者的感知医疗服务可及性。我们建议该工具可用于其他患者群体，并考虑增加地理可达性等其他结构。
