Psychometric Validation of the Cantonese Version of the Patient-Centered Primary Care Instrument for Multimorbid Patients in Hong Kong.

INTRODUCTION

Patient-centered care and assessing patient experience is essential for improving healthcare quality, particularly for individuals with multimorbidity, who require coordinated and personalized care. Despite its importance, no valid and reliable tool is currently available for measuring patient-centered care for the multimorbid population within the Cantonese cultural context, limiting local healthcare evaluations. This study recruited 500 multimorbid participants from a General Outpatient Clinic in Sha Tin, Hong Kong, to validate the translated and culturally adapted patient-centeredness assessment instrument.

OBJECTIVES

This study aimed to adapt and validate the Cantonese version of the Patient-Centered Primary Care instrument, originally developed by Cramm and Nieboer, for use among Hong Kong residents with multimorbidity.

METHODS

The 35-item Cantonese version of the Patient-Centered Primary Care instrument was translated into Cantonese using standard translation procedures. A cross-sectional telephone survey was conducted from August to November 2023, recruiting 500 middle-aged Hong Kong residents with multimorbidity (≥2 chronic conditions). Confirmatory factor analysis was conducted to test the 8-dimensional structure, while reliability (McDonald's Omega) and validity (discriminant, convergent, and criterion-related) were assessed.

RESULTS

Confirmatory factor analysis demonstrated marginally acceptable fit indices: SRMR = 0.073, RMSEA = 0.064, CFI = 0.871, and TLI = 0.856. The discriminant validity was supported (HTMT ratios <0.85). The total Omega value for the multidimensional scale was .91, with total Omega values for each dimension ranging from .79 to .95, demonstrating strong reliability. Convergent validity was confirmed via significant correlations with the Patient Enablement Instrument (PEI;  < .001). Criterion-related validity was not established, as no significant evidence supported.

CONCLUSIONS

The Cantonese version of PCPC instrument demonstrates acceptable reliability and validity for assessing patient-centered care in Hong Kong's multimorbid population. This tool addresses the lack of relevant assessment measures, provides a practical solution for evaluating patient centeredness in this specific clinical context.