Annica Rosvall, Malin Axelsson, Magdalena Annersten Gershater, Ervin Toth, Bang Christensen Karl, Christine Kumlien
Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden.
Department of Gastroenterology, Skåne University Hospital, Malmö, Lund University, Lund, Sweden.
J Eval Clin Pract. 2025 Aug;31(5):e70220. doi: 10.1111/jep.70220.
RATIONALE, AIMS AND OBJECTIVES: Colonoscopy, though common, can be uncomfortable, necessitating routine assessment of patient experience per European guidelines. Positive patient experiences are crucial as they influence willingness for repeat procedures. Patient-reported experience measures (PREMs) effectively capture patient perspectives through surveys, empowering patients to influence healthcare quality. These surveys identify areas for improvement and inform research, enhancing healthcare and its quality. The Patient Experience Colonoscopy Scale (PECS) is a colonoscopy-specific PREM that measures adult patient experience after an elective colonoscopy. It consists of items derived from the patient's perspective and has been found to be content valid. The PECS is multidimensional and divided into five constructs: health motivation, discomfort, information, a caring relationship, and understanding. The current study aims to evaluate the measurement properties of the new PREM, called the PECS regarding reliability and construct validity.
The sample comprised 331 adult patients who had undergone an elective colonoscopy at a University Hospital in Sweden. The PECS was evaluated using intraclass correlation coefficients, confirmatory factor analysis, and multi- and unidimensional Rasch analyses.
The test-retest reliability was acceptable, with an average intraclass correlation coefficient of 0.72. Construct validity was tested with three different techniques. The confirmatory factor analysis revealed that the theoretical bifactor model containing the five constructs was supported. The multi- and unidimensional Rasch analyses showed that approximately 60% of the items had acceptable values. Some violation of local independence and some evidence of differential item functioning with respect to age and gender were identified, but they all made subject matter sense. The PECS is well-targeted to patients with less positive experiences. The overall evaluation of the construct validity showed the PECS has acceptable measurement properties.
The PECS is a reliable and valid 30-item colonoscopy-specific PREM that can play an important role in gathering data for research and quality improvement initiatives that seek to incorporate patient perspectives on colonoscopy experiences. Some potential areas for improvement were found, but the PECS is ready to be utilised in clinical practice for the purpose of collecting patient experiences.
原理、目的和目标：结肠镜检查虽然常见，但可能会让人感到不适，因此根据欧洲指南需要对患者体验进行常规评估。积极的患者体验至关重要，因为它们会影响患者接受重复检查的意愿。患者报告体验测量（PREM）通过调查有效地捕捉患者的观点，使患者能够影响医疗质量。这些调查确定了需要改进的领域，并为研究提供信息，从而提高医疗保健及其质量。患者体验结肠镜检查量表（PECS）是一种针对结肠镜检查的PREM，用于测量择期结肠镜检查后成年患者的体验。它由从患者角度得出的项目组成，并且已被发现具有内容效度。PECS是多维的，分为五个结构：健康动机、不适、信息、关怀关系和理解。本研究旨在评估名为PECS的新PREM在可靠性和结构效度方面的测量属性。
样本包括331名在瑞典一家大学医院接受择期结肠镜检查的成年患者。使用组内相关系数、验证性因子分析以及多维度和单维度Rasch分析对PECS进行评估。
重测信度可以接受，平均组内相关系数为0.72。使用三种不同技术测试了结构效度。验证性因子分析表明包含五个结构的理论双因子模型得到支持。多维度和单维度Rasch分析表明大约60%的项目具有可接受的值。发现了一些违反局部独立性的情况以及一些关于年龄和性别的项目功能差异的证据，但它们都具有实际意义。PECS针对体验不太积极的患者。对结构效度的总体评估表明PECS具有可接受的测量属性。
PECS是一种可靠且有效的、包含30个项目的针对结肠镜检查的PREM，在为研究和质量改进计划收集数据方面可以发挥重要作用，这些计划旨在纳入患者对结肠镜检查体验的观点。发现了一些潜在的改进领域，但PECS已准备好在临床实践中用于收集患者体验。
