Background
Methods
Scale Development
Identification of relevant and salient domains
Domains | Details | Description |
---|---|---|
(1) Perceived system-level factor | ||
Health care system | Being able to find a doctor who | For example, bulk billing is the Medicare rebate system in Australia, which allows GPs to provide their services at no 'out-of-pocket' cost to patients |
bulk bills | ||
(2) Perceived environmental/organisational-level factors
| ||
Accessibility to health services | Accessibility to transport | Transport to GP clinic: public/own car to access to health services. |
Travel time to health services | Travel time to the regular source of medical care. | |
The cost of seeing a general practitioner | Out-of-pocket cost from patients related to the consultation fee. | |
Availability of health services | A number of doctors to choose from | Available doctors for patients to choose e.g. female doctors. |
Able to see preferred doctor | A doctor who patients would like to see. | |
Amount of time to get an appointment | Elapsed time between initial request and the date of the appointment to see a GP. | |
Waiting time | Waiting time in GP's office or clinic. | |
Consultation time | How long GP consults with the patient. | |
GP's attitudes towards patients | Inter-personal care scale | GP's perceived attitude towards patients. |
(3) Interpersonal-level
| ||
Family sources | Regular source of care | Regularly visit GPs at one practice or one doctor. |
Social support | Social support | Support from family, friends and neighbours |
(4) Individual-level
| ||
Attitudes and beliefs towards health care | Value of general practitioners | Patients' perceptions towards doctors. |
Value of health care | Patients' perceptions towards health care. | |
Value of good health | Patients' attitudes towards doctor's advice about improving their health. |
Identification and/or adaptation of existing items and where necessary, development of new items
Development of a draft questionnaire and review by an expert panel
Pre-testing and piloting of the reviewed questionnaire
Collection of data using a mail survey
Study variables | No of cases | Percentage |
---|---|---|
Gender | ||
Male | 155 | 40.7 |
Female | 226 | 59.3 |
Age groups
| ||
25-29 | 46 | 12.1 |
30-34 | 65 | 17.1 |
35-39 | 61 | 16.0 |
40-44 | 54 | 14.2 |
45-49 | 54 | 14.2 |
50-54 | 40 | 10.5 |
55-59 | 38 | 10.0 |
60-64 | 23 | 6.0 |
Education
| ||
Bachelor degree and higher | 151 | 39.6 |
Diploma | 40 | 10.5 |
Vocational | 65 | 17.1 |
Non post-school qualification | 116 | 30.4 |
Missing | 9 | 2.4 |
Household income
| ||
Aus $52 000 or more | 206 | 54.1 |
$31 200-51 999 | 60 | 15.7 |
< $31 199 | 40 | 10.5 |
Don't wish to answer | 70 | 18.4 |
Missing | 5 | 1.3 |
Evaluation of the psychometric properties of the scales
Ethics
Results
Scales/items | Factors and item loadings (Varimax Rotation) | |||||
---|---|---|---|---|---|---|
1 | 2 | 3 | 4 | 5 | ||
Social support
| ||||||
a. | People don't visit me as often as I would like. |
0.565
| -0.163 | -0.126 | -0.014 | 0.246 |
b. | I often need help from other people but can't get it. a
|
0.662
| -0.056 | -0.105 | -0.065 | 0.250 |
c. | I seem to have a lot of friends. a
|
0.512
| 0.155 | -0.028 | 0.004 | 0.026 |
d. | I don't have anyone that I can really talk to. |
0.785
| -0.002 | -0.076 | -0.026 | 0.213 |
e. | I have no one to lean on in times of trouble. |
0.796
| 0.020 | -0.044 | -0.056 | 0.216 |
f. | There is someone who can always cheer me up. a
|
0.701
| 0.086 | 0.084 | 0.118 | -0.110 |
g. | I often feel very lonely. |
0.709
| -0.085 | -0.161 | 0.014 | 0.274 |
h. | I enjoy the time I spend with the people who are important to me. a
|
0.529
| 0.168 | 0.036 | 0.099 | -0.269 |
i. | When something is on my mind, just talking with the people I know makes me feel better. a
|
0.510
| 0.180 | 0.099 | 0.183 | -0.262 |
j. | When I need someone to help me, I can usually find someone. |
0.745
| 0.179 | 0.037 | 0.105 | - 0.202 |
Perceived interpersonal care
| ||||||
a. | The amount of time the doctor spends with you? | 0.116 |
0.848
| 0.028 | -0.096 | -0.012 |
b. | The doctor's patience with your questions or worries? | 0.116 |
0.882
| -0.041 | -0.064 | 0.028 |
c. | The doctor's caring and concern for you? | 0.080 |
0.889
| -0.038 | -0.066 | 0.020 |
Concerns about availability of and accessibility to health care
| ||||||
a. | Being able to find a doctor who bulk bills | -0.174 | -0.148 |
0.520
| -0.039 | -0.092 |
b. | Having a number of doctors to choose from | -0.014 | 0.042 |
0.577
| 0.122 | -0.056 |
c. | Being able to see my preferred doctor every time | -0.033 |
0.523
| 0.328 | 0.124 | 0.049 |
d. | The amount of time it takes to get an appointment | 0.059 | 0.102 |
0.662
| -0.016 | -0.022 |
e. | The cost of seeing a doctor | -0.163 | -0.052 |
0.681
| 0.009 | -0.098 |
f. | Transport to see a doctor or medical centre | -0.089 | 0.113 |
0.691
| 0.066 | 0.094 |
g. | The amount of time to travel to see a doctor | -0.024 | -0.006 |
0.704
| 0.083 | 0.124 |
h. | The amount of time I have to wait in the waiting room | 0.111 | -0.094 |
0.650
| -0.088 | -0.104 |
i. | The amount of time I get to spend with a doctor | 0.058 | 0.227 |
0.626
| 0.020 | 0.030 |
Value of General practitioners
| ||||||
a. | The care I have received from doctors in the last few years has been good | 0.195 |
0.733
| -0.101 | -0.004 | 0.126 |
b. | Doctors belong to a very high status profession | 0.060 | 0.414 | 0.022 | 0.106 | 0.098 |
c. | A person understands their own health better than most doctors do | 0.061 | -0.024 | -0.009 | -0.091 | 0.388 |
d. | It is very important to choose your doctor carefully to get good medical care a
| 0.057 | -0.415 | -0.154 | -0.177 | 0.102 |
e. | Many doctors are more interested in their incomes than in making sure everyone receives adequate medical care | 0.212 | 0.237 | -0.242 | -0.056 | 0.342 |
Value of good health
| ||||||
a. | Get more rest and sleep | -0.018 | 0.031 | 0.009 |
0.757
| 0.053 |
b. | Get more exercise | 0.087 | 0.020 | -0.006 |
0.718
| -0.011 |
c. | Cut down on the amount of work you do | 0.042 | 0.056 | -0.019 |
0.701
| 0.043 |
d. | Stop eating some favourite foods | 0.003 | 0.055 | 0.056 |
0.714
| 0.043 |
e. | Spend more time doing things with family and friends | 0.100 | 0.112 | 0.120 |
0.716
| -0.070 |
Attitudes towards health care
| ||||||
a. | If you wait long enough, you can get over almost any disease without seeing a doctor | 0.086 | 0.052 | -0.058 | 0.105 |
0.631
|
b. | I avoid seeing a doctor whenever possible | 0.022 | 0.151 | 0.067 | 0.097 |
0.751
|
c. | I only go to a doctor if there is no other option | 0.010 | 0.101 | 0.019 | 0.068 |
0.789
|
d. | Even if a person is feeling okay, they should get a general examination or check up every year or so a
| -0.053 | 0.339 | -0.007 | 0.163 | 0.063 |
Total Variance Explained
|
12.78%
|
10.94%
|
10.01%
|
7.93%
|
6.80%
|
Scales | Number of Cases | Number of Items (possible score range) | Mean (SD) | Cronbach's Alpha
|
---|---|---|---|---|
Social Support | 381 | 10 (10-60) | 44.78 (7.64) | 0.86 |
Perceived interpersonal care | 378 | 5 (5-25) | 15.02 (3.88) | 0.87 |
Concerns about availability of health care and accessibility to health care | 323a
| 8 (8-40) | 29.22 (5.65) | 0.80 |
Value of good health | 381 | 5 (5-20) | 15.12 (2.51) | 0.79 |
Attitudes towards health care | 381 | 3 (3-18) | 11.69 (3.25) | 0.75 |