Adaption and validation of Nijmegen continuity questionnaire to recognize the influencing factors of continuity of care for hypertensive patients in China

Abstract

BackgroundContinuity of care (COC) has become a primary point of concern for care providers in both developed and developing countries, which is regarded as the “cornerstone of care” and an “essential element” of good health care. A robust and proper instrument is of necessity to identify problems and evaluate intervention aimed at improving continuity of care. This study aimed to adapt Nijmegen continuity questionnaire (NCQ) into a Chinese version (NCQ-C) and to delineate the status of COC as well as explore its influencing factors for hypertensive patients in China.MethodsA forward-back-translation procedure was adopted for the determination of the adaption of NCQ. Then a total of 448 patients completed questionnaires and 24-h ambulatory blood pressure monitoring (ABPM). Proper indexes were calculated to test the reliability and validity of NCQ-C. Logistic analysis were used to detect the influencing factors of COC.ResultsThe NCQ-C had excellent intraclass correlation coefficient of 0.855 and internal consistency of seven dimensions varied from 0.907 to 0.944. The item-content validity index ranged from 0.71 to 1.00. For construct validity, seven-factor structure was confirmed as original questionnaire and all the fit indices indicated acceptable levels. Gender, education level, medical insurance and frequency of family visits, blood pressure level, depression status as well as general health perception were demonstrated to be statistically related to COC.ConclusionsIn addition, all the parameters of ABPM were negatively significant with COC. The NCQ-C has shown acceptable level of reliability and validity. The related factors of COC should arouse care providers’ attention.

Continuity of care experienced by patients in a multi-institutional pancreatic care network: a pilot study

“…Because of this low sample size, the lack of observed correlations between NCQ scores and certain patient characteristics should be interpreted with caution. Especially since other studies with larger sample sizes have described correlations between continuity of care and patient characteristics such as sex, diagnosis or number of outpatient visits [ 12 , 13 , 21 ]. Therefore, there is the possibility a type II error occurred.…”

“…The questionnaire is considered a reliable, comprehensive instrument that measures COC as a multidimensional concept, regardless of comorbidity or care setting. It has been validated in primary care and secondary care, as well as in other languages [ 12 , 13 , 18 ]. To adequately assess COC, patients should have had contact with a GP or medical specialist in the previous year.…”

“…Previous studies have evaluated the experienced COC in different patient populations, such as oral cancer [ 12 ], hypertension [ 13 ], and rehabilitation [ 14 ]. However, to date no study has assessed COC in patients with (pre) malignant pancreatic tumors.…”

Validação de tecnologia para autocuidado do familiar cuidador de pacientes oncológicos paliativos domiciliares

“…The relevance attested in this study is in agreement with other studies that also validated materials, such as in the instrument for nursing consultations to pregnant women with diabetes mellitus, in which the CVI ranged from 0.80 to 1 (15) . On the other hand, the booklet on excess weight for adults with hypertension was evaluated with a global CVI of 0.78 (16) and another study carried out in China obtained indices varying from 0.71 to 1, with a validity of 0.78 (17) . These latter results are low in comparison to those presented in the present study.…”

Measuring continuity of ambulatory cardiovascular care: a cross-sectional study on the applicability of the Nijmegen Continuity Questionnaire in Germany

“…Its applicability in other countries and health systems was assumed for countries where the general practitioner plays a gatekeeping role similar to the Netherlands, but it had not been tested [ 7 , 8 ]. Since then, sporadic and mixed international evidence has been gathered on the applicability of various translations in several settings: A Chinese version of the NCQ in a sample of hypertension patients in a tertiary clinic [ 9 ], a Norwegian version in a sample of patients with various conditions in rehabilitation institutions [ 10 ] and a Hebrew version in a sample of patients with various cancer types who received oral anticancer therapy in oncology centres [ 11 ]. Our study aimed to manufacture a German translation of the NCQ and examine its applicability and usefulness to measure continuity of care in the ambulatory setting in Germany regarding general practitioners and practice-based cardiologists from the patients’ perspectives.…”