Patient-centered infertility questionnaire for female clients (PCIQ-F): part I: questionnaire development

Abstract

Background Patient-centered care is an essential component of health care quality. To achieve patient-centered care, health care authorities should have a clear definition and an applicable tool to measure the extent of its application. The real concept of patient centeredness should be developed by the patients themselves. We aimed to demonstrate a way to develop a draft Arabic patient-centered infertility care (PCIC) questionnaire for females clients following practical steps that address women with infertility. Methods An iterative process of questionnaire development was undertaken by combining two approaches: the steps proposed by Robert F. DeVellis for scale development and the recommended practices for questionnaire development and testing in the European statistical system. We attempted to develop the draft questionnaire that involved conceptualization and operationalization, generation of an item pool, development of the questionnaire format, review of the initial item pool by experts, and consideration of validation items for inclusion. Results We generated an item pool from in-depth interviews with 14 women who sought infertility care within 6 months before the interview time. We then added more items from a literature review. The item pool contained 123 items distributed through 10 domains. Ten women with infertility were included for face validation. Then, experts with backgrounds in Obstetrics and Gynecology, Family Medicine, and Public Health reviewed the item pool using content validation (n = 10 professors and/or specialists). The item pool was finally reduced to 57 items. We developed the draft Arabic patient-centered infertility care questionnaire for female clients (PCIQ-F) with three sections, including 66 items: background variables, PCIC experience variables, and a general question about the quality of infertility care in the health facility. The draft questionnaire was further reviewed and edited last by experts in preparation for part 2, which will test the questionnaire and prepare the final version. Conclusion The PCIQ-F questionnaire development is a multi-step iterative process started and ended by the target users as experts. Experts’ participation in infertility care and in questionnaire format development had a great impact on questionnaire development and conflict resolution. We recommend this transparent and replicable approach for new instrument developers; it is likely to generate a questionnaire that is valid and acceptable to target users. The draft PCIQ-F questionnaire is ready for testing of its psychometric properties before the final version to measure the PCIC level in health facilities.

Person‐centred sexual and reproductive health: A call for standardized measurement

“…infertility and cervical cancer care 43,44 ; prevention, detection and counselling for gender-based violence, 45 especially in low-and middle-income countries (LMICs). For example, while quality of care frameworks have been developed for gender-based violence services, there are few standardized measures that operationalize people's experiences of care.…”

“…First, these measures were developed for services related to contraception, abortion, prenatal and intrapartum care. While there have been other person‐centred care measures for services such as HIV, 41 there is relatively little on standardized person‐centred care measures for other services such as other STIs 42 ; infertility and cervical cancer care 43,44 ; prevention, detection and counselling for gender‐based violence, 45 especially in low‐ and middle‐income countries (LMICs). For example, while quality of care frameworks have been developed for gender‐based violence services, there are few standardized measures that operationalize people's experiences of care 45 .…”