Contextualizing the Revised Patient Perception of Patient-Centeredness (PPPC-R) Scale in Primary Healthcare settings: a Validity and Reliability Evaluation Study

Abstract

Background The Patient Perception of Patient-Centeredness (PPPC) scale in English was recently revised, and it is necessary to test this instrument in different primary care populations. Aim This study aimed to assess the validity and reliability of a Chinese version of the PPPC scale. Design Delphi method was used to address the content validity of the PPPC scale by calculating the Content Validity Index, Content Validity Ratio, the adjusted Kappa, and the Item Impact Score. Confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) were used to assess the construct validity of the PPPC scale. The internal consistency was also assessed. Setting/participants A cross-sectional survey included 188 outpatients in Guangzhou city and 108 outpatients in Hohhot city from community health service centers or stations. Results The 21 items in the scale were relevant to the component they belong to. The Item-level Content Validity Index for each item was higher than 0.79, and the average Scale-level content validity index was 0.97 in each evaluation round. The initial proposed 4-factor CFA model did not fit adequately. Still, we found a 3-factor solution based on our EFA model and the validation via the CFA model (model fit:χ2=294.573, P<0.001, RMSEA=0.044, CFI=0.981; factor loadings: 0.553 to 0.888). Cronbach's α also indicated good internal consistency reliability: The overall Cronbach's α was 0.922, and the Cronbach's α for each factor was 0.851, 0.872, and 0.717, respectively. Conclusions The Chinese version of the PPPC scale provides a valuable tool for evaluating patient-centered medical service quality.