Patient Continuity of Care Questionnaire in a cardiac sample: A Confirmatory Factor Analysis

Abstract

<jats:sec><jats:title>Objective</jats:title><jats:p>Even though continuity is essential after discharge, there is a lack of reliable questionnaires to measure and assess patients’ perceptions of continuity of care. The Patient Continuity of Care Questionnaire (PCCQ) addresses the period before and after discharge from hospital. However, previous studies show that the factor structure needs to be confirmed and validated in larger samples, and the aim of this study was to evaluate the psychometric properties of the PCCQ with focus on factor structure, internal consistency and stability.</jats:p></jats:sec><jats:sec><jats:title>Design</jats:title><jats:p>A psychometric evaluation study. The questionnaire was translated into Swedish using a forward–backward technique and culturally adapted through cognitive interviews (n=12) and reviewed by researchers (n=8).</jats:p></jats:sec><jats:sec><jats:title>Setting</jats:title><jats:p>Data were collected in four healthcare settings in two Swedish counties.</jats:p></jats:sec><jats:sec><jats:title>Participants</jats:title><jats:p>A consecutive sampling procedure included 725 patients discharged after hospitalisation due to angina, acute myocardial infarction, heart failure or atrial fibrillation.</jats:p></jats:sec><jats:sec><jats:title>Measurement</jats:title><jats:p>To evaluate the factor structure, confirmatory factor analyses based on polychoric correlations were performed (n=721). Internal consistency was evaluated by ordinal alpha. Test–retest reliability (n=289) was assessed with intraclass correlation coefficient (ICC).</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The original six-factor structure was overall confirmed, but minor refinements were required to reach satisfactory model fit. The standardised factor loadings ranged between 0.68 and 0.94, and ordinal alpha ranged between 0.82 and 0.95. All subscales demonstrated satisfactory test–retest reliability (ICC=0.76–0.94).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The revised version of the PCCQ showed sound psychometric properties and is ready to be used to measure perceptions of continuity of care. High ordinal alpha in some subscales indicates that a shorter version of the questionnaire can be developed.</jats:p></jats:sec>

Study on the Correlation between Continuity of Care and Quality of Life for Patients with Coronary Heart Disease

“…The results of this study will allow medical teams to understand that CHD patients' receiving information during their hospitalization directly affects their QoL [1,24]. Therefore, in order to improve the QoL of CHD patients, it is necessary for their medical team to strengthen the CoC for patients during hospitalization, especially in terms of information transfer, and to provide patients with sufficient information that affects their personal health or follow-up care to improve their QoL [24,26].…”

“…When the patient perceived that the medical team understood his/her expectations and beliefs, felt confident that the current medical team would continue to take care of him/her after discharge from the hospital, and received information support, they had a better QoL. It is important for heart disease patients to receive related information on disease progression, disease symptoms, and post-discharge treatment [24]. Therefore, in order to clinically relieve the symptoms of CHD patients, in addition to improving the function and prognosis of CHD patients, it is necessary to strengthen the CoC by the medical team regarding the transmission of information to the patients so that the patients can know their own diagnosis, prescription drugs, and disease-related supportive information, such as diet instructions [25].…”

“…The CoC of CHD patients after discharge is a top priority, especially as the current health-care system is becoming more and more complex and fragmented [25]. Clinically, CoC relies on early screening by first-line care personnel when patients are admitted to the hospital, their creation of a complete physical and mental assessment, and referring to a case manager for discharge preparation services in a timely manner, in order for CHD patients to have good CoC [24]. Providing discharge preparation services during the patient's hospitalization can improve communication and coordination between the patients, their family members, and inter-professional teams to facilitate patients receiving information on medication, rehabilitation, proper diet, physical activity, psychology, and society after they are discharged from the hospital.…”

Continuity of Care and Self-Management among Patients with Stroke: A Cross-Sectional Study

“…Lack of disease care-related information during hospitalization and failure to establish relationships and communication between healthcare personnel and patients could hinder the latter's implementation of self-management [41]. Therefore, medical teams must ensure and strengthen the COC among patients during hospitalization in order to convey sufficient personal health information and provide appropriate care according to patients' individuality to improve self-management [42,43].…”

Measurement tools that assess the quality of transitional care from patients' perspective: A literature review

“…Structural validity was NA because a CFA was not reported in the original and Chinese versions (Chen & Chen, 2017; Hadjistavropoulos et al, 2008). Contrastingly, the Swedish version was “+” and obtained good fit indices (Säfström et al, 2020). The studies of the Italian version did not explicitly state that a CFA was performed, but fit indices were reported; thus, it was rated as “?” (Facchinetti et al, 2021).…”