Health Services OutPatient Experience questionnaire: factorial validity and reliability of a patient-centered outcome measure for outpatient settings in Italy

Abstract

PurposeThe patient-centered approach to health care does not seem to be sufficiently developed in the Italian context, and is still characterized by the biomedical model. In addition, there is a lack of validated outcome measures to assess outpatient experience as an aspect common to a variety of settings. The current study aimed to evaluate the factorial validity, reliability, and invariance across sex of the Health Services OutPatient Experience (HSOPE) questionnaire, a short ten-item measure of patient-centeredness for Italian adult outpatients. The rationale for unidimensionality of the measure was that it could cover global patient experience as a process common to patients with a variety of diseases and irrespective of the phase of treatment course.Patients and methodsThe HSOPE was compiled by 1,532 adult outpatients (51% females, mean age 59.22 years, standard deviation 16.26) receiving care in ten facilities at the Santa Maria alle Scotte University Hospital of Siena, Italy. The sample represented all the age cohorts. Twelve percent were young adults, 57% were adults, and 32% were older adults. Exploratory and confirmatory factor analyses were conducted to evaluate factor structure. Reliability was evaluated as internal consistency using Cronbach’s α. Factor invariance was assessed through multigroup analyses.ResultsBoth exploratory and confirmatory analyses suggested a clearly defined unidimensional structure of the measure, with all the ten items having salient loadings on a single factor. Internal consistency was excellent (α=0.95). Indices of model fit supported a single-factor structure for both male and female outpatient groups. Young adult outpatients had significantly lower scores on perceived patient-centeredness relative to older adults. No significant difference emerged on patient-centeredness between male and female outpatients.ConclusionThe HSOPE questionnaire seemed to be a tool with high acceptability and excellent psychometric properties to measure patient-centeredness as a unidimensional construct. Limitations and implications for future research are discussed.

Psychometric properties and relations with coping and family strain of the Health Services and Caregiver Experience questionnaire (HSCE): an outcome measure of informal caregivers’ experience for inpatient care in Italy

“…The tool is part of a battery of self-report tools created for the assessment of experience of care pathways, including the Health Service & Inpatient Experience questionnaire (HS&PE; [ 14 ]) and the Health Services Outpatient Experience (HSOPE; [ 15 ]). The questionnaire consists of three sections.…”

Patient Experience in Home Respiratory Therapies: Where We Are and Where to Go

“…Distinct instruments to assess the patient’s experience with healthcare are available. Table 2 summarizes 14 instruments designed to assess the patient’s experience with the provision of care in different clinical settings [29,30,31,32,33,34], hospital [35,36,37,38], primary care [39,40], intermediate care [41], and community [33,41]. The majority of such instruments are generic and designed to be used for a diverse range of health conditions.…”

“…Only two developed instruments were tested with the carers of children [31,39]. English is the most common language used, with some instruments also in Norwegian [31,38,39], Italian [35,41], and Spanish [29]. Most instruments already had some of their psychometric properties explored, namely, their reliability and validity.…”

Which kind of psychometrics is adequate for patient satisfaction questionnaires?

“…If one investigates present patient satisfaction questionnaires by only considering the content of the items, then most of the present questionnaires exclusively consist of causal items, 3 – 4 , 8 – 18 , 22 – 23 that is, these questionnaires would be classified as indices. There are, however, also several questionnaires in which different kinds of items are applied together.…”

“…Some authors of previous publications about patient satisfaction have already analyzed the relationships between sum scores and direct assessments of satisfaction, 12 , 13 , 15 , 18 , 22 , 36 but only some of them 13 , 18 , 22 explicitly described this as a test of validity. In a similar way, some authors of previous publications have computed multivariate linear regressions with the items as independent variables and a global satisfaction rating as a dependent variable, 4 , 15 , 36 but without using the results of these computations as scoring weights.…”