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01.12.2012 | Research article | Ausgabe 1/2012 Open Access

BMC Health Services Research 1/2012

Psychometric properties of the patient assessment of chronic illness care measure: acceptability, reliability and validity in United Kingdom patients with long-term conditions

Zeitschrift:
BMC Health Services Research > Ausgabe 1/2012
Autoren:
Jo Rick, Kelly Rowe, Mark Hann, Bonnie Sibbald, David Reeves, Martin Roland, Peter Bower
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1472-6963-12-293) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

PB, MR, BS and DR are applicants on the grant. JR and KR conducted the survey, with PB. MH conducted the analyses. PB and JR wrote the paper and all other authors commented on earlier drafts. All authors read and approved the final manuscript.

Abstract

Background

The Patient Assessment of Chronic Illness Care (PACIC) is a US measure of chronic illness quality of care, based on the influential Chronic Care Model (CCM). It measures a number of aspects of care, including patient activation; delivery system design and decision support; goal setting and tailoring; problem-solving and contextual counselling; follow-up and coordination. Although there is developing evidence of the utility of the scale, there is little evidence about its performance in the United Kingdom (UK). We present preliminary data on the psychometric performance of the PACIC in a large sample of UK patients with long-term conditions.

Method

We collected PACIC, demographic, clinical and quality of care data from patients with long-term conditions across 38 general practices, as part of a wider longitudinal study. We assess rates of missing data, present descriptive and distributional data, assess internal consistency, and test validity through confirmatory factor analysis, and through associations between PACIC scores, patient characteristics and related measures.

Results

There was evidence that rates of missing data were high on PACIC (9.6% - 15.9%), and higher than on other scales used in the same survey. Most PACIC sub-scales showed reasonable levels of internal consistency (alpha = 0.68 – 0.94), responses did not demonstrate high skewness levels, and floor effects were more frequent (up to 30.4% on the follow up and co-ordination subscale) than ceiling effects (generally <5%). PACIC demonstrated preliminary evidence of validity in terms of measures of long-term condition care. Confirmatory factor analysis suggested that the five factor PACIC structure proposed by the scale developers did not fit the data: reporting separate factor scores may not always be appropriate.

Conclusion

The importance of improving care for long-term conditions means that the development and validation of measures is a priority. The PACIC scale has demonstrated potential utility in this regard, but further assessment is required to assess low levels of completion of the scale, and to explore the performance of the scale in predicting outcomes and assessing the effects of interventions.
Zusatzmaterial
Additional file 1: Figure S1. Distribution of PACIC total scores. (DOC 36 KB)
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Additional file 2: Figure S2. Distribution of PACIC patient activation scores. (DOC 36 KB)
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Additional file 3: Figure S3. Distribution of PACIC Delivery system design scores. (DOC 36 KB)
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Additional file 4: Figure S4. Distribution of PACIC Goal setting scores. (DOC 36 KB)
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Additional file 5: Figure S5. Distribution of PACIC Problem solving scores. (DOC 36 KB)
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Additional file 6: Figure S6. Distribution of PACIC follow up scores. (DOC 36 KB)
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Additional file 7: Figure S7. Distribution of HCCQ scores scores. (DOC 38 KB)
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Additional file 8: Figure S8. Distribution of QIPP scores. (DOC 36 KB)
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Additional file 9: Figure S9. Distribution of single item patient satisfaction scores. (DOC 35 KB)
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Authors’ original file for figure 1
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Authors’ original file for figure 2
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Authors’ original file for figure 5
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Authors’ original file for figure 6
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Authors’ original file for figure 7
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Authors’ original file for figure 8
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Authors’ original file for figure 9
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