scholarly journals Development and psychometric properties of surveys to assess provider perspectives on the barriers and facilitators of effective care transitions

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maurice C. Johnson ◽  
Helen Liu ◽  
Joann Sorra ◽  
Jane Brock ◽  
Brianna Gass ◽  
...  
Keyword(s):  
Patient Care ◽  
Psychometric Properties ◽  
Transitional Care ◽  
Care Transitions ◽  
Model Fit ◽  
Fit Indices ◽  
Pilot Testing ◽  
Composite Measures ◽  
Effective Care

Abstract Background The quality of the discharge process and effective care transitions between settings of care are critical to minimize gaps in patient care and reduce hospital readmissions. Few studies have explored which care transition components and strategies are most valuable to patients and providers. This study describes the development, pilot testing, and psychometric analysis of surveys designed to gain providers’ perspectives on current practices in delivering transitional care services. Methods We underwent a comprehensive process to develop items measuring unique aspects of care transitions from the perspectives of the three types of providers (downstream, ambulatory, and hospital providers). The process involved 1) an environmental scan, 2) provider interviews, 3) survey cognitive testing, 4) pilot testing, 5) a Stakeholder Advisory Group, 6) a Scientific Advisory Council, and 7) a collaborative Project ACHIEVE (Achieving Patient-Centered Care and Optimized Health in Care Transitions by Evaluating the Value of Evidence) research team. Three surveys were developed and fielded to providers affiliated with 43 hospitals participating in Project ACHIEVE. Web-based survey administration resulted in 948 provider respondents. We assessed response variability and response missingness. To evaluate the composites’ psychometric properties, we examined intercorrelations of survey items, item factor loadings, model fit indices, internal consistency reliability, and intercorrelations between the composite measures and overall rating items. Results Results from psychometric analyses of the three surveys provided support for five composite measures: 1) Effort in Coordinating Patient Care, 2) Quality of Patient Information Received, 3) Organizational Support for Transitional Care, 4) Access to Community Resources, and 5) Strength of Relationships Among Community Providers. All factor loadings and reliability estimates were acceptable (loadings ≥ 0.40, α ≥ 0.70), and the fit indices showed a good model fit. All composite measures positively and significantly correlated with the overall ratings (0.13 ≤ r ≤ 0.71). Conclusions We determined that the items and composite measures assessing the barriers and facilitators to care transitions within this survey are reliable and demonstrate satisfactory psychometric properties. The instruments may be useful to healthcare organizations and researchers to assess the quality of care transitions and target areas of improvement across different provider settings.

scholarly journals Development and Psychometric Properties of Surveys to Assess Patient and Family Caregiver Experience With Care Transitions

2021 ◽  
Author(s):  
Joann Sorra ◽  
Katarzyna Zebrak ◽  
Deborah Carpenter ◽  
Theresa Famolaro ◽  
John Rauch ◽  
...  
Keyword(s):  
Psychometric Properties ◽  
Family Caregivers ◽  
Internal Consistency ◽  
Transitional Care ◽  
Care Delivery ◽  
Care Transitions ◽  
Sample Sizes ◽  
Composite Measures ◽  
At Home

Abstract Background The purpose of this study was to develop and administer surveys that assess patient and caregiver experience with care transitions and examine the psychometric properties of the surveys. The surveys were designed to include the transitional care services or components of care, provided in the hospital and at home, that matter most to patients and their family caregivers, as well as their assessments of the overall quality of the transitional care they received. Methods Patients were recruited prior to discharge from 43 U.S. hospitals. The analysis dataset included responses from 9,282 patients, 1,245 Time 1 caregivers (who helped the patient in the hospital), and 1,749 Time 2 caregivers (who helped the patient at home). The psychometric properties of the survey items and composite measures were examined for each of the three surveys, including (1) item response variability and missing data, (2) exploratory factor analysis, (3) internal consistency and site-level reliability, and (4) correlations among the outcome composite measures and with other survey items. Items that performed poorly across multiple analyses were dropped from the final instruments. Results Overall, the final patient and caregiver surveys had acceptable psychometric properties, with a few exceptions. Exploratory factor analyses supported the composite measures, which had acceptable internal consistency reliability—Overall Quality of Transitional Care (patient and caregiver surveys), Patient Overall Health (patient survey) and Caregiver Effort/Stress (caregiver surveys). All surveys had acceptable site-level reliability except when the sample sizes needed to achieve 0.70 site-level reliability were higher than the actual sample sizes in the dataset. In all surveys, the Overall Quality of Transitional Care composite measure was significantly correlated with other composite measures and most of the survey items. Conclusions The final patient, T1 caregiver, and T2 caregiver surveys are psychometrically sounds and can be used by health systems, hospitals, and researchers to assess patient and caregiver experience with care transitions. Results from these surveys can be used as the basis for making improvements to transitional care delivery that are centered on what matters most to patients and their family caregivers.

scholarly journals Development and psychometric properties of surveys to assess patient and family caregiver experience with care transitions

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Joann Sorra ◽  
Katarzyna Zebrak ◽  
Deborah Carpenter ◽  
Theresa Famolaro ◽  
John Rauch ◽  
...  
Keyword(s):  
Psychometric Properties ◽  
Family Caregiver ◽  
Transitional Care ◽  
Care Transitions ◽  
Internal Consistency Reliability ◽  
Patient Survey ◽  
Care Patient ◽  
Composite Measures ◽  
Stay Time

Abstract Background The purpose of this study was to develop and administer surveys that assess patient and family caregiver experiences with care transitions and examine the psychometric properties of the surveys. The surveys were designed to ask about 1) the transitional care services that matter most to patients and their caregivers and 2) care outcomes, including the overall quality of transitional care they received, patient self-reported health, and caregiver effort/stress. Methods Survey items were developed based on a review of the literature, existing surveys, focus groups, site visits, stakeholder and expert input, and patient and caregiver cognitive interviews. We administered mail surveys with telephone follow up to patients recently discharged from 43 U.S. hospitals. Patients identified the caregivers who helped them during their hospital stay (Time 1 caregiver) and when they were home (Time 2 caregiver). Time 1 and Time 2 caregivers were surveyed by telephone only. The psychometric properties of the survey items and outcome composite measures were examined for each of the three surveys. Items that performed poorly across multiple analyses, including those with low variability and/or a high missing data, were dropped except when they were conceptually important. Results The analysis datasets included responses from 9282 patients, 1245 Time 1 caregivers and 1749 Time 2 caregivers. The construct validity of the three proposed outcome composite measures—Overall Quality of Transitional Care (patient and caregiver surveys), Patient Overall Health (patient survey) and Caregiver Effort/Stress (caregiver surveys) —was supported by acceptable exploratory factor analysis results and acceptable internal consistency reliability. Site-level reliability was acceptable for the two patient outcome composite measures, but was low for Caregiver Effort/Stress (< 0.70). In all surveys, the Overall Quality of Transitional Care outcome composite measure was significantly correlated with other outcome composite measures and most of the single-item measures. Conclusions Overall, the final patient and caregiver surveys are psychometrically sound and can be used by health systems, hospitals, and researchers to assess the quality of care transitions and related outcomes. Results from these surveys can be used to improve care transitions, focusing on what matters most to patients and their family caregivers.

Not Very Powerful

2020 ◽  
Vol 36 (4) ◽  
pp. 563-572 ◽  
Author(s):  
David Goretzko ◽  
Florian Pargent ◽  
Larissa N. N. Sust ◽  
Markus Bühner
Keyword(s):  
Psychometric Properties ◽  
Model Fit ◽  
Partial Credit Model ◽  
General Applicability ◽  
Reliability Estimates ◽  
Confirmatory Factor ◽  
German Original ◽  
Systematic Pattern ◽  
Vague Quantifiers

Abstract. Several guidelines on how to construct questionnaire items exist, even though the literature lacks empirical evidence for their effectiveness. To investigate whether the addition of negations and vague quantifiers worsens the psychometric properties of an established questionnaire, 872 participants completed one version of the Positive and Negative Affect Schedule (PANAS) – the German original, a negated version, a version with vague quantifiers or a version with both negations and vague quantifiers. Reliability estimates, item-total correlations, Confirmatory Factor Analysis (CFA) model fit, and fit to the Partial Credit Model (PCM) were compared among the four conditions. No PANAS version was clearly superior as no systematic pattern in the psychometric properties was found. Our findings question the general applicability of the guidelines of item construction as well as the effectiveness of widely used statistical analyses assessing the quality of scales. The results should encourage researchers to put a stronger focus on careful item construction as relying on psychometric properties might not be sufficient to develop valid questionnaires.

A Psychometric Study of the Quality Perception Questionnaire

2012 ◽  
Vol 71 (2) ◽  
pp. 101-106 ◽  
Author(s):  
Raffaele Cioffi† ◽  
Anna Coluccia ◽  
Fabio Ferretti ◽  
Francesca Lorini ◽  
Aristide Saggino ◽  
...  
Keyword(s):  
Structural Equation ◽  
Factor Model ◽  
Equation Modeling ◽  
Fit Indices ◽  
Quality Perception ◽  
Italian Survey ◽  
Confirmatory Factor ◽  
Instrument Measuring ◽  
Hospital Structures

The present paper reexamines the psychometric properties of the Quality Perception Questionnaire (QPQ), an Italian survey instrument measuring patients’ perceptions of the quality of a recent hospital admission experience, in a sample of 4400 patients (Mage = 56.42 years; SD = 19.71 years, 48.8% females). The 14-item survey measures four factors: satisfaction with medical doctors, nursing staff, auxiliary staff, and hospital structures. First, we tested two models using a confirmatory factor analysis (structural equation modeling): a four orthogonal factor and a four oblique factor model. The SEM fit indices and the χ² difference suggested the acceptance of the second model. We then did a simulation using a bootstrap with 1000 replications. Results confirmed the four oblique factor solution. Third, we tested whether there were significant differences with respect to age or sex. The multivariate general linear model showed no significant differences in the factors with respect to sex or age.

Assessing Social Skills in Health Professional Services

2005 ◽  
Vol 21 (3) ◽  
pp. 173-181
Author(s):  
Francisco Gil ◽  
Jesús Sanz ◽  
María Paz García-Vera ◽  
José M. León ◽  
Silvia Medina ◽  
...  
Keyword(s):  
Social Skills ◽  
Health Services ◽  
Health Professional ◽  
Aggressive Behavior ◽  
Psychometric Properties ◽  
Internal Consistency ◽  
Intervention Program ◽  
Professional Services ◽  
Quality Of Health Services

Abstract. The quality of health services depends on the contribution of all the professionals involved in the system, including certain groups, usually forgotten and underrated, such as the health-transport technicians (HTT). With the aim of improving this group's performance, an intervention program, focusing on the development of the workers' technical and social skills, was designed in a collective of enterprises. Information about the first stage of this program, consisting of the assessment of these workers' social skills, is offered in this study. A specific questionnaire was developed: The Health-Transport Technicians Social Skills Questionnaire (HTT-SSQ), made up of three scales (assertive, passive, and aggressive behavior). It was administered to a large sample (N = 530) from the above-mentioned association. The psychometric properties of the questionnaire were analyzed, with quite satisfactory indexes of internal consistency and factor validity, and the group's deficiencies (excess or deficit) were evaluated.

Is That Measure Really One-Dimensional?

Methodology ◽  
2018 ◽  
Vol 14 (4) ◽  
pp. 188-196 ◽  
Author(s):  
Esther T. Beierl ◽  
Markus Bühner ◽  
Moritz Heene
Keyword(s):  
Model Fit ◽  
Nuisance Parameters ◽  
Factorial Validity ◽  
Fit Indices ◽  
Analysis Model ◽  
Factor Analysis Model ◽  
One Dimensional ◽  
Confirmatory Factor Analysis Model ◽  
Cutoff Values ◽  
Confirmatory Factor

Abstract. Factorial validity is often assessed using confirmatory factor analysis. Model fit is commonly evaluated using the cutoff values for the fit indices proposed by Hu and Bentler (1999) . There is a body of research showing that those cutoff values cannot be generalized. Model fit does not only depend on the severity of misspecification, but also on nuisance parameters, which are independent of the misspecification. Using a simulation study, we demonstrate their influence on measures of model fit. We specified a severe misspecification, omitting a second factor, which signifies factorial invalidity. Measures of model fit showed only small misfit because nuisance parameters, magnitude of factor loadings and a balanced/imbalanced number of indicators per factor, also influenced the degree of misfit. Drawing from our results, we discuss challenges in the assessment of factorial validity.

Development and Validation of a Questionnaire to Assess Parent Reported Quality of Life Pre and Post Vision Therapy in a Population with Autism Spectrum Disorder

2019 ◽  
pp. 195-207
Keyword(s):  
Quality Of Life ◽  
Autism Spectrum Disorder ◽  
Social Behavior ◽  
Psychometric Properties ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Visual Behavior ◽  
The Mean ◽  
Vision Therapy

Background: Autism spectrum disorder is characterized in part by atypical behavior in the communication, social, and visual domains. Success in vision therapy is judged not only by changes in optometric findings, but through improvement in quality of life involving communication, social behavior and visual behavior. It would therefore be beneficial to have a validated questionnaire to assess parent reported quality of life pre and post vision therapy specific to patients with autism spectrum disorder. To our knowledge, a questionnaire of this nature has not been previously published in the literature. Methods: Questionnaire items were generated through surveying medical literature based on symptoms in three different categories: visual behavior, social behavior and communication. A pool of 34 questions was developed initially and then with thorough discussion with other experts, a 20-point questionnaire was developed with each item reflected in the construct concept. A draft of 20 questions was then sent to 10 subject experts with clinical experience in the field for more than 20 years, to review the pooled items. Validity and reliability was established prior to assessing the psychometric properties of the ASD/QOL-VT. Prospective observational study was conducted for a duration of 18 months. The study included individuals undergoing vision therapy in the age range of 3 to 15 years who had been diagnosed with ASD. The questionnaire was administered to parents of these children prior to the start of vision therapy. All subjects completed a minimum of 60 vision therapy sessions. The questionnaire was readministered after completing 60 sessions of vision therapy. Results: Cronbach’s alpha value for this questionnaire was 0.93, which reflected very good internal consistency. Factorial analysis yielded four factors with an Eigen value exceeding 1.0 which accounted for 68% variation in the model. The Cronbach alpha value for subscales identified by factorial analysis is 0.97 indicating excellent internal reliability. The mean pre vision therapy social behavior, communication and visual behavior score was 12.0±3.21, 17.07±4.57 and 26.97±6.41 respectively. The mean post vision therapy scores for social behavior, communication and visual behavior was 8.27±4.16, 11.33±5.27 and 17.93±6.52 respectively. On paired t test, the mean difference in score was statistically significant with P<0.001 in all three subcategories. Conclusions: Our study presents the development of a valid and reliable parent questionnaire, the ASD/QOL-VT, that judges communication, social behavior, and visual behavior in autism. Results of the study conducted indicate that vision therapy can result in significant improvements in the quality of life of patients with ASD as judged by their parents. This is evidenced by statistically significant changes in psychometric properties of the ASD/QOL-VT in social behavior, communication and visual behavior.

scholarly journals More comprehensively measuring quality of life in life-threatening illness: the McGill Quality of Life Questionnaire – Expanded

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
S. Robin Cohen ◽  
Lara B. Russell ◽  
Anne Leis ◽  
Javad Shahidi ◽  
Pat Porterfield ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Second Order ◽  
Model Fit ◽  
Life Questionnaire ◽  
Quality Of Life Questionnaire ◽  
Healthcare Environment ◽  
Life Threatening Illness ◽  
Life Threatening ◽  
Order Factor

Abstract Background Domains other than those commonly measured (physical, psychological, social, and sometimes existential/spiritual) are important to the quality of life of people with life-threatening illness. The McGill Quality of Life Questionnaire (MQOL) – Revised measures the four common domains. The aim of this study was to create a psychometrically sound instrument, MQOL – Expanded, to comprehensively measure quality of life by adding to MQOL-Revised the domains of cognition, healthcare, environment, (feeling like a) burden, and possibly, finance. Methods Confirmatory factor analyses were conducted on three datasets to ascertain whether seven new items belonged with existing MQOL-Revised domains, whether good model fit was obtained with their addition as five separate domains to MQOL-Revised, and whether a second-order factor representing overall quality of life was present. People with life-threatening illnesses (mainly cancer) or aged > 80 were recruited from 15 healthcare sites in seven Canadian provinces. Settings included: palliative home care and inpatient units; acute care units; oncology outpatient clinics. Results Good model fit was obtained when adding each of the five domains separately to MQOL-Revised and for the nine correlated domains. Fit was acceptable for a second-order factor model. The financial domain was removed because of low importance. The resulting MQOL-Expanded is a 21-item instrument with eight domains (fit of eight correlated domains: Comparative Fit Index = .96; Root Mean Square Error of Approximation = .033). Conclusions MQOL-Expanded builds on MQOL-Revised to more comprehensively measure the quality of life of people with life-threatening illness. Our analyses provide validity evidence for the MQOL-Expanded domain and summary scores; the need for further validation research is discussed. Use of MQOL-Expanded will enable a more holistic understanding of the quality of life of people with a life-threatening illness and the impact of treatments and interventions upon it. It will allow for a better understanding of less commonly assessed but important life domains (cognition, healthcare, environment, feeling like a burden) and their relationship to the more commonly assessed domains (physical, psychological, social, existential/spiritual).

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