Christalle Eva, Kriston Levente, Zeh Stefan, Führes Hannah, Schellhorn Alica, Hahlweg Pola, Zill Jördis Maria, Härter Martin, Scholl Isabelle
Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Germany.
Health Expect. 2025 Jun;28(3):e70296. doi: 10.1111/hex.70296.
We previously developed the EPAT-64, a patient-reported experience measure designed to assess patient-centeredness (PC) across 16 dimensions of the validated integrative model of PC. While its modular structure makes it highly adaptable to examine certain dimensions of PC, generating an overall PC score requires assessing all 64 items. This is often challenging in routine settings with limited resources. Therefore, we developed and psychometrically tested a 16-item short form.
We conducted a cross-sectional study involving adult inpatients and outpatients receiving treatment for cardiovascular diseases, cancer, musculoskeletal disorders and mental health conditions in Germany. To ensure comprehensive content coverage, we selected one item per dimension based on content relevance as well as item characteristics such as item difficulty and item-total correlation. We assessed the structural validity of a unidimensional model using confirmatory factor analysis (CFA), measured reliability with McDonald's Omega and evaluated construct validity by investigating the intercorrelation of the EPAT-16 sum score with measures of general health status and satisfaction with care.
All items of the final EPAT-16 showed high acceptability and good item-total correlations, with approximately two-thirds demonstrating appropriate item difficulty. CFA showed a slight misfit of the unidimensional model, but a high average variance explained. McDonald's Omega showed high reliability. All hypotheses about construct validity were confirmed.
The EPAT-16 demonstrated good psychometric properties, making it a feasible tool for assessing overall PC when resource constraints preclude using the full EPAT-64. In particular, it can be used in routine care for feedback and quality improvement, as well as in research to assess relationships with other relevant variables. Since its items were designed generically, it can be used for different medical conditions and settings, for example for public reporting. Future research should evaluate the EPAT-16 in diverse, independent patient samples to confirm that its positive characteristics are consistent across different populations and cultures.
Patients did not participate as active members of the research team. However, for the research proposal, several patient organizations provided positive feedback on the study aims and their relevance, signed a collaboration agreement and later supported recruitment by distributing study information.
我们之前开发了EPAT - 64，这是一种患者报告的体验测量工具，旨在根据经过验证的以患者为中心的综合模型的16个维度来评估以患者为中心（PC）的程度。虽然其模块化结构使其高度适用于检查PC的某些维度，但生成总体PC分数需要评估所有64个项目。在资源有限的常规环境中，这通常具有挑战性。因此，我们开发并对一个16项的简版进行了心理测量测试。
我们进行了一项横断面研究，涉及在德国接受心血管疾病、癌症、肌肉骨骼疾病和心理健康状况治疗的成年住院患者和门诊患者。为确保全面涵盖内容，我们根据内容相关性以及项目难度和项目与总分相关性等项目特征，每个维度选择了一个项目。我们使用验证性因子分析（CFA）评估单维模型的结构效度，用麦克唐纳欧米伽系数测量信度，并通过研究EPAT - 16总分与总体健康状况测量值及护理满意度之间的相互关系来评估结构效度。
最终的EPAT - 16的所有项目都显示出高可接受性和良好的项目与总分相关性，约三分之二的项目显示出适当的项目难度。CFA显示单维模型略有拟合不佳，但平均方差解释率较高。麦克唐纳欧米伽系数显示出高信度。所有关于结构效度的假设都得到了证实。
EPAT - 16显示出良好的心理测量特性，使其成为在资源限制排除使用完整的EPAT - 64时评估总体PC的可行工具。特别是，它可用于常规护理中的反馈和质量改进，以及在研究中评估与其他相关变量的关系。由于其项目是通用设计的，它可用于不同的医疗状况和环境，例如用于公开报告。未来的研究应在不同的、独立的患者样本中评估EPAT - 16，以确认其积极特征在不同人群和文化中是一致的。
患者没有作为研究团队的积极成员参与。然而，对于研究提案，几个患者组织对研究目的及其相关性提供了积极反馈，签署了合作协议，随后通过分发研究信息支持招募工作。
