Design and validation of an instrument to evaluate Person-Centered care in health services

被引：0

作者：

Lehmann-Mendoza, Rodolfo ^{[1
]}

Cortes-Moreno, Gabriela Yanet ^{[2
]}

Sarabia-Gonzalez, Odet ^{[3
]}

Figuerola-Escoto, Rosa Paola ^{[4
]}

Luna, David ^{[5
]}

Gonzalez-Mundo, Ilicia ^{[2
]}

Caselin-Ledezma, Ruben ^{[6
]}

Vazquez-Davila, Roberto Arturo ^{[7
]}

Martinez-Arredondo, Hilario Ascencion ^{[8
]}

机构：

[1] Subdirecc Serv Salud Petr Mexicanos, Mexico City, Mexico

[2] Petr Mexicanos, Coordinac Nacl Invest, Mexico City, Mexico

[3] Serv Salud Petr Mexicanos, Subgerencia Cal, Mexico City, Mexico

[4] Inst Politecn Nacl, Ctr Interdisciplinario Ciencias Salud, Mexico City, Mexico

[5] Inst Nacl RehabilLuis Guillermo Ibarra Ibarra, Unidad Invest Multidisciplinaria Salud, Mexico City, Mexico

[6] Univ Popular Autonoma Estado Puebla, Puebla, Mexico

[7] Petr Mexicanos, Subgerencia Educ & Desarrollo Salud, Mexico City, Mexico

[8] Petr Mexicanos, Gerencia Med Prevent, Mexico City, Mexico

来源：

ARCHIVES OF PUBLIC HEALTH | 2024年 / 82卷 / 01期

关键词：

Person-centered care; Instrument design; Instrument validation; Exploratory factorial analysis; Confirmatory factorial analysis; PATIENT; QUALITY; PERCEPTIONS; DECISIONS; SYSTEM;

D O I：

10.1186/s13690-024-01324-2

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

BackgroundThe concept of quality in health care has evolved, placing greater importance on the patient's needs, culture, and social context, as well as their participation in clinical decision-making, as highlighted by Mead and Bower's Person-Centered Care Model. The aim of the present study was to design and validate an instrument to assess the extent to which healthcare services provided by PEMEX (Petr & oacute;leos Mexicanos) offer person-centered care according to user perceptions.MethodsThe first phase comprised the development of 57 items based on the analysis of responses from an open-ended questionnaire administered to 30 users of Pemex healthcare services. This questionnaire was designed considering the four factors of the person-centered care model, however, the high correlation between the 4 factors (i.e., r >= .80) indicated an overfactoring effect and consequently an increase in the risk of overfitting. Therefore, an exhaustive analysis of the instrument was performed, starting with the review of the individual behavior of each item, and carrying out exploratory and confirmatory factor analysis. Using a sample of 330 individuals, an exploratory factor analysis was perfomed. Afterward, a confirmatory factorial analysis was carried out with 335 participants. Finally, a new confirmatory factorial analysis included 130 participants due to the refinements made in the previous phase. Internal consistency was assessed using Cronbach's alpha and McDonald's omega at every phase.ResultsThe exploratory factor analysis retained 35 items in a single factor that accounted for 49% of the variance with an internal consistency of Cronbach's alpha and McDonald's omega = 0.97. Because the factorial structure by confirmatory factorial analysis was unsatisfactory, the initial model was refined, leading to the retention of 11 items and a final model with adjustment index of chi 2 = 127.53, chi 2/gl = 2.89, RMSEA = 0.07, IC RMSEA 0.06 to 0.09, TLI = 0.95 and CFI = 0.96, with an internal consistency of Cronbach's alpha and McDonald's omega = 0.93. Due to the refinements, a new confirmatory factorial analysis was conducted with suitable goodness-of-fit criteria in most items (chi 2 = 151.44, chi 2/gl = 3.43, RMSEA = 0.13, IC RMSEA 0.11 to 0.16, TLI = 0.93 and CFI = 0.94), resulting in a Cronbach's alpha and McDonald's omega = 0.98.ConclusionsThe instrument exhibits suitable psychometric properties to be employed to measure the degree to which medical care is patient centered. This instrument represents a strategy for promoting an innovative healthcare model.

引用

页数：12