Evaluating the Structure of the Patient Assessment of Chronic Illness Care (PACIC) Survey from the Patient’s Perspective

Abstract

The underlying factorial structure of PACIC, which reflects the patient perspective, is dynamic, patient-centered, and differs from the original 5-factor model that was more aligned with views of healthcare delivery stakeholders.

Patient Experience in an Era of Primary Care Transformation: Revisiting the PACIC

“…The original 20-item questionnaire consists of 5 subscales [(10]. Although prior research indicates that the PACIC summary score is suitable for use with patients with a variety of chronic illnesses, several studies have raised questions about the validity of the subscales suggesting that it may not be appropriate to use them separately or interpret them as suggested by the developers [13, 14]. Prior analyses of the PACIC factor structure have used a variety of analytic methods with samples varying greatly in origin, size, and clinical characteristics; those that have employed both exploratory and confirmatory factor analysis are limited in that they have typically used the same or split samples of patients assessed at a single time point [10, 13–24].…”

“…Also, as evidenced by numerous queries and requests for technical assistance received by PACIC developers, clinician and health care system stakeholders are increasingly interested in using the PACIC to support quality improvement activities, indicating that it is more practical to use than similar instruments that are longer or that require licensing fees. The PACIC’s utility as a research tool and quality improvement instrument, however, is dependent upon the stability and validity of its constructs or subscales [14]. Healthcare systems must be able to trust that the subscale scores can be used to reliably detect gaps in chronic illness care and to guide specific quality improvement efforts in response.…”

Adaptación y validación de la versión chilena del cuestionario “Evaluación de la Atención de Enfermedades Crónicas para pacientes”

“…Es así como Gigiu et al 31 encontraron 1 a 2 factores, señalando que su estructura correspondería más bien a un constructo unidimensional, similar a lo reportado por Aung et al 34 , quienes identificaron una estructura de un factor. Por otra parte, Fan et al 35 . hallaron un modelo de 4 y no de 5 factores.…”

“…Es así como, la revisión de literatura revela una amplia evidencia de la utilización del modelo de cuidados crónicos 7,8,[10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] y de la evaluación de los cuidados proporcionados a los usuarios con en-fermedad crónica utilizando como herramienta el cuestionario Patient Assessment of Chronic Illness Care (PACIC) [24][25][26][27][28][29][30][31][32][33][34][35][36] . Este instrumento proporciona una evaluación de la atención de enfermedades crónicas desde la perspectiva del paciente y, en particular, del apoyo al automanejo 24 .…”

“…En la actualidad se dispone de versiones traducidas a distintos idiomas [24][25][26][27][28][29][30][31][32][33][34][35] , entre las que se encuentran las versiones al español, realizadas por Barceló et al 36 y Aragones et al 26 . Estos últimos realizaron la validación del instrumento al español en hispanoparlantes residentes en Estados Unidos de Norteamérica, reportando niveles satisfactorios de confiabilidad y validez.…”