Construction and content validation of a measurement tool to evaluate person-centered therapeutic relationships in physiotherapy services

Abstract

This study sought to develop a tool for evaluating person-centered therapeutic relationships within physiotherapy services, and to examine the content validity of the same. Methods A mixed qualitative and quantitative study was performed in three distinct phases: 1) the items were generated based on a literature review and a content analysis of focus groups of patients and physiotherapists; 2) an e-Delphi survey process was performed based on three rounds to select and refine the proposed questionnaire; 3) two rounds of cognitive interviews were conducted to evaluate the comprehension of items, the clarity of language and the appropriateness and relevance of content. Results Thirty-one items were generated based on the seven domains identified after the analysis of four focus groups of physiotherapists and four patient focus groups. Nine experts participated in the e-Delphi survey. Fifty-five patients participated in the two rounds of the cognitive pre-tests. Participating patients were from public and private physical therapy services. Based on the participants' suggestions, four items were removed, and four were added, whereas 16 were reworded.

Construction, Factor Structure, and Internal Consistency Reliability of the Hospital Physical Therapy Perceived Satisfaction Questionnaire (H-PTPS)

“…The individual item contribution to the factorial structure of the instrument is consistent with other studies [ 5 , 19 , 25 , 26 ]. More particularly, the most repeated questions in the literature (Questions 8, 9, 16, 17, 18 and 20), which explain most of the variance in the user’s satisfaction construct, belong to the information shared in the medical staff-patient relationship.…”

“…Recently, some authors have identified factors similar to that included in the H-PTPS, such as Rodríguez Nogueira et al, who included a factor referred to as “environment” with items such as “I observe a lack of coordination between the team of professionals (physiotherapists, doctors, aids, administration staff, etc.) who attend me” [ 5 ]. In this sense, potential reasons for the lack of notable improvements in physical therapy patient outcomes and health expenditures could be related to traditional medical care models.…”

“…More particularly, the most repeated questions in the literature (Questions 8, 9, 16, 17, 18 and 20), which explain most of the variance in the user’s satisfaction construct, belong to the information shared in the medical staff-patient relationship. Specifically, Question 17 of the H-PTPS is included as part of domain two, referred to as “physiotherapist-patient communication”, which is similar to the factor referred to as “capacity of communication” from the study conducted by Rodríguez Nogueira et al [ 5 ] on the validation of a questionnaire focused on the person-centered therapeutic relationships in physiotherapy services. On the other hand, other items included in the H-PTPS have also been reported by other studies, presenting acceptable psychometric properties.…”

“…This review was based on levels of patient satisfaction in the health care context across different biomedical fields, as well as focused on measuring instruments evaluating the levels of quality of health care and the user’s satisfaction. The Hospital Physical Therapy Perceived Satisfaction questionnaire (H-PTPS) was based on the content of previous validations published by Beattie et al [ 17 ] and other authors [ 5 , 17 , 19 , 23 , 24 , 25 , 26 ]. Moreover, the H-PTPS requested the patient to answer questions specifically relating to his/her experience receiving physical therapy, as indicated by Goldstein et al [ 18 ].…”

“…In recent years, the theoretical models of quality of care highlight the importance of person-centered care to achieve optimal levels of patient satisfaction. Numerous domains have been identified in patient satisfaction such as the interpersonal component of interventions, and the expectations about health care services after rehabilitation [ 4 , 5 , 6 , 7 ]. Several authors have contributed to the paradigm referred to as the expectancy-disconfirmation, explaining the expectation–satisfaction link in the formation of satisfaction judgments of patients who receive physical therapy [ 8 ].…”