The Patient Assessment of Chronic Illness Care produces measurements along a single dimension: results from a Mokken analysis

Gibbons, Christopher; Small, Nicola; Rick, Jo; Burt, Jenni; Hann, Mark; Bower, Peter

doi:10.1186/s12955-017-0638-4

Cited by 8 publications

(11 citation statements)

References 23 publications

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“…The absence of significant association between PACIC and potential determinants is common in the literature and puts into perspective the notion that it is the best instrument to assess patient experience, particularly in the context of primary interdisciplinary care. The PACIC was developed for individuals with chronic illness to measure specific actions or qualities of care congruent with the CCM,52 and most recent analyses of PACIC supported the use of the overall summary score 50,54–56,86,87. However, the fact that we did not find strong associations with hypothesized predictors raises potential questions regarding the five-dimension structure of the PACIC.…”

Section: Discussionmentioning

confidence: 72%

<p>Determinants Of Patient Experience With Low Back Pain Interdisciplinary Care: A Pre-Post Interventional Study</p>

Gogovor

Visca

Ware

et al. 2019

JPR

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Background and purposeMeasuring patients’ experiences of health services has become an essential part of quality of care reporting and a means for identifying opportunities for improvement. This study aimed to evaluate change in patient experience in an interdisciplinary primary care program and to estimate the impact on patient experience of sociodemographic, function, pain and general health status, resource utilization, and process variables.Patients and methodsA 6-month interdisciplinary care program for individuals with low back pain (LBP) was implemented at four primary care settings and evaluated using an observational pre/post study design. The change in patient experience was evaluated using the Patient Assessment of Chronic Illness Care questionnaire (PACIC) completed at baseline and 6 months post-intervention (n=132). Descriptive and multivariable analyses were performed using SAS version 9.3.ResultsThe average patient age was 57 (SD: 14) years of age and the majority were female (53%). The mean overall PACIC score was 2.6 (SD: 1.1) at baseline and 3.6 (SD: 0.9) at 6 months. The experience of care improved for 62% of the participants based on the minimal clinically important difference (MCID). No significant determinants of overall PACIC change score were identified in the multivariable regression models.ConclusionThe lack of association of hypothesized determinants requires further examination of the properties of the PACIC and with a larger sample. Future investigation is needed on the relationship between improved patient experience and outcomes.

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Section: Discussionmentioning

confidence: 72%

<p>Determinants Of Patient Experience With Low Back Pain Interdisciplinary Care: A Pre-Post Interventional Study</p>

Gogovor

Visca

Ware

et al. 2019

JPR

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“…[15] The combination of the two methodologies has been shown to be useful in previous research conducted by members of our group and others. [16–19] Where scale data did not conform to the assumptions of either the Mokken or the partial credit model, an iterative process of item reduction was undertaken to remove the violating items from the analysis. [20] The iterative process involved assessments of scalability, model and item fit to the PCM, category threshold disordering, local dependency, and differential item functioning (DIF).…”

Section: Methodsmentioning

confidence: 99%

Assessing mental health service user and carer involvement in physical health care planning: The development and validation of a new patient-reported experience measure

et al. 2019

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Background People living with serious mental health conditions experience increased morbidity due to physical health issues driven by medication side-effects and lifestyle factors. Coordinated mental and physical healthcare delivered in accordance with a care plan could help to reduce morbidity and mortality in this population. Efforts to develop new models of care are hampered by a lack of validated instruments to accurately assess the extent to which mental health services users and carers are involved in care planning for physical health. Objective To develop a brief and accurate patient-reported experience measure (PREM) capable of assessing involvement in physical health care planning for mental health service users and their carers. Methods We employed psychometric and statistical techniques to refine a bank of candidate questionnaire items, derived from qualitative interviews, into a valid and reliable measure involvement in physical health care planning. We assessed the psychometric performance of the item bank using modern psychometric analyses. We assessed unidimensionality, scalability, fit to the partial credit Rasch model, category threshold ordering, local dependency, differential item functioning, and test-retest reliability. Once purified of poorly performing and erroneous items, we simulated computerized adaptive testing (CAT) with 15, 10 and 5 items using the calibrated item bank. Results Issues with category threshold ordering, local dependency and differential item functioning were evident for a number of items in the nascent item bank and were resolved by removing problematic items. The final 19 item PREM had excellent fit to the Rasch model fit (x 2 = 192.94, df = 1515, P = .02, RMSEA = .03 (95% CI = .01-.04). The 19-item bank had excellent reliability (marginal r = 0.87). The correlation between questionnaire scores at baseline and 2-week follow-up was high (r = .70, P < .01) and 94.9% of assessment pairs were within the Bland Altman limits of agreement. Simulated CAT demonstrated that assessments could be made using as few as 10 items (mean SE = .43). Discussion We developed a flexible patient reported outcome measure to quantify service user and carer involvement in physical health care planning. We demonstrate the potential to substantially reduce assessment length whilst maintaining reliability by utilizing CAT.

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“…Chronic illness is continuing to increase worldwide along with the demand to improve the care of those diagnosed with a chronic illness (Gibbons et al, 2017). Examples of chronic illness include but are not limited to arthritis, diabetes, cancer, and coronary heart disease.…”

Section: Literature Reviewmentioning

confidence: 99%

“…Examples of chronic illness include but are not limited to arthritis, diabetes, cancer, and coronary heart disease. Treating and caring for individuals with chronic illnesses has become a healthcare priority as the increasing prevalence adds stress to not only the patient but also the healthcare system (Gibbons et al, 2017). Researchers have suggested that individuals with chronic illness face uncertainty including significant disruption to family life, well-being, and quality of life as they experience unpredictable and incurable conditions (Hurt et al, 2017).…”

Section: Literature Reviewmentioning

confidence: 99%

Managing Uncertainty in Chronic Illness From Patient Perspectives

Brown

Hayden

Klingman

et al. 2020

JENHP

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Chronic illness is an increasing concern in the United States as the Centers for Disease Control and Prevention reports that 50% of adults have at least one chronic illness. When individuals must adjust to chronic illness, they may experience uncertainty regarding the illness, prognosis, and symptoms. The purpose of this qualitative, phenomenological study was to explore the management strategies of uncertainty in chronic illness from patients’ perspectives. Merle Mishel’s uncertainty in illness theory was the framework used to explore the lives of individuals diagnosed and living with chronic illness. In-depth interviews were conducted with eight individuals who have chronic disease. Results revealed themes that individuals with chronic illness do experience uncertainty and that it impacts almost all aspects of their lives. Some of the themes identified were chronic illness, uncertainty, impact of uncertainty on daily living, coping or managing uncertainty, and communication from the healthcare team about uncertainty. The individuals expressed changes in daily activities and retraining their minds to accept their new normal. This study offers coping and management strategies that healthcare professionals can implement into treatment plans to improve the quality of life for individuals with uncertainty in chronic illness. The information produced from this study will aid healthcare providers in understanding the need to address the uncertainty at diagnoses and offer ways to assist patients in coping and managing uncertainty

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The Patient Assessment of Chronic Illness Care produces measurements along a single dimension: results from a Mokken analysis

Cited by 8 publications

References 23 publications

<p>Determinants Of Patient Experience With Low Back Pain Interdisciplinary Care: A Pre-Post Interventional Study</p>

<p>Determinants Of Patient Experience With Low Back Pain Interdisciplinary Care: A Pre-Post Interventional Study</p>

Assessing mental health service user and carer involvement in physical health care planning: The development and validation of a new patient-reported experience measure

Managing Uncertainty in Chronic Illness From Patient Perspectives

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