The family experiences of in-hospital care questionnaire in severe traumatic brain injury (FECQ-TBI): a validation study

Abstract

BackgroundFamily members are important for support and care of their close relative after severe traumas, and their experiences are vital health care quality indicators. The objective was to describe the development of the Family Experiences of in-hospital Care Questionnaire for family members of patients with severe Traumatic Brain Injury (FECQ-TBI), and to evaluate its psychometric properties and validity.MethodsThe design of the study is a Norwegian multicentre study inviting 171 family members. The questionnaire developmental process included a literature review, use of an existing instrument (the parent experience of paediatric care questionnaire), focus group with close family members, as well as expert group judgments. Items asking for family care experiences related to acute wards and rehabilitation were included. Several items of the paediatric care questionnaire were removed or the wording of the items was changed to comply with the present purpose. Questions covering experiences with the inpatient rehabilitation period, the discharge phase, the family experiences with hospital facilities, the transfer between departments and the economic needs of the family were added. The developed questionnaire was mailed to the participants. Exploratory factor analyses were used to examine scale structure, in addition to screening for data quality, and analyses of internal consistency and validity.ResultsThe questionnaire was returned by 122 (71%) of family members. Principal component analysis extracted six dimensions (eigenvalues > 1.0): acute organization and information (10 items), rehabilitation organization (13 items), rehabilitation information (6 items), discharge (4 items), hospital facilities-patients (4 items) and hospital facilities-family (2 items). Items related to the acute phase were comparable to items in the two dimensions of rehabilitation: organization and information. All six subscales had high Cronbach’s alpha coefficients >0.80. The construct validity was confirmed.ConclusionThe FECQ-TBI assesses important aspects of in-hospital care in the acute and rehabilitation phases, as seen from a family perspective. The psychometric properties and the construct validity of the questionnaire were good, hence supporting the use of the FECQ-TBI to assess quality of care in rehabilitation departments.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1884-6) contains supplementary material, which is available to authorized users.

Family members’ experience with in-hospital health care after severe traumatic brain injury: a national multicentre study

“…Using paired samples t - tests, eight out of ten items had significantly higher scores (better experiences) in the acute phase compared with the rehabilitation phase. Examples of questions with marked differences are [ 20 ]: “To what extent do you think the personnel demonstrated thoughtfulness and care for the patient?”; “To what extent do you think the personnel seemed professionally competent?”; “To what extent do you think the personnel was interested in hearing your opinions as a relative?” and “To what extent do you think the personnel gave you information and explanations that you understood?”…”

“…To assess the family members’ experience with the health care services, the newly developed family experiences of care questionnaire after traumatic brain injury (FECQ-TBI) was applied [ 20 ]. The FECQ-TBI contains six subscales and 39 items: acute organization and information (10 items), rehabilitation organization (13 items), rehabilitation information (6 items), discharge (4 items), hospital facilities patient (4 items) and hospital facilities family member (2 items).…”

“…The FECQ-TBI contains six subscales and 39 items: acute organization and information (10 items), rehabilitation organization (13 items), rehabilitation information (6 items), discharge (4 items), hospital facilities patient (4 items) and hospital facilities family member (2 items). The 10 items related to the acute phase can be divided into two subscales that corresponds to the rehabilitation items: acute organization (5 items; Chronbach’s alpha 0.89) and acute information (5 items; Chronbach’s alpha 0.94) [ 20 ]. In addition, 7 single-item questions were included: overall satisfaction (2 items), incorrect treatment (3 items), economic needs (1 item) and if children involved were taken care of (1 item).…”

“…The FEC-TBI has shown good construct validity and internal consistency with Cronbach’s alpha coefficients of 0.80–0-94 [ 20 ]. Each item was scored from 1 to 5, representing the worst and best family member experience, respectively.…”

“…To address a gap in the relevant literature, a multidimensional scale including aspects of the family member’s satisfaction with and experience of health care services after TBI have recently been developed and validated [ 20 ]. The family experiences of care questionnaire in severe traumatic brain injury (FECQ-TBI) is measuring family members’ experiences from both the acute and rehabilitation phase after severe TBI [ 20 ].…”