Development of the Primary Care Quality-Homeless (PCQ-H) instrument: a practical survey of homeless patients' experiences in primary care
Autor: | Kertesz, Stefan G, Pollio, David E, Jones, Richard N, Steward, Jocelyn, Stringfellow, Erin J, Gordon, Adam J, Johnson, Nancy K, Kim, Theresa A, Daigle, Shanette G, Austin, Erika L, Young, Alexander S, Chrystal, Joya G, Davis, Lori L, Roth, David L, Holt, Cheryl L |
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Rok vydání: | 2014 |
Předmět: |
Male
Primary Health Care Psychometrics patient satisfaction homeless health care homeless persons item response theory Homelessness Professional-Patient Relations Middle Aged patient-centered care patient-centered outcomes research Good Health and Well Being Clinical Research Applied Economics Surveys and Questionnaires Ill-Housed Persons Public Health and Health Services Health Policy & Services Humans survey methodology Female Quality of Health Care |
Zdroj: | Medical care, vol 52, iss 8 |
Popis: | BackgroundHomeless patients face unique challenges in obtaining primary care responsive to their needs and context. Patient experience questionnaires could permit assessment of patient-centered medical homes for this population, but standard instruments may not reflect homeless patients' priorities and concerns.ObjectivesThis report describes (a) the content and psychometric properties of a new primary care questionnaire for homeless patients; and (b) the methods utilized in its development.MethodsStarting with quality-related constructs from the Institute of Medicine, we identified relevant themes by interviewing homeless patients and experts in their care. A multidisciplinary team drafted a preliminary set of 78 items. This was administered to homeless-experienced clients (n=563) across 3 VA facilities and 1 non-VA Health Care for the Homeless Program. Using Item Response Theory, we examined Test Information Function (TIF) curves to eliminate less informative items and devise plausibly distinct subscales.ResultsThe resulting 33-item instrument (Primary Care Quality-Homeless) has 4 subscales: Patient-Clinician Relationship (15 items), Cooperation among Clinicians (3 items), Access/Coordination (11 items), and Homeless-specific Needs (4 items). Evidence for divergent and convergent validity is provided. TIF graphs showed adequate informational value to permit inferences about groups for 3 subscales (Relationship, Cooperation, and Access/Coordination). The 3-item Cooperation subscale had lower informational value (TIF |
Databáze: | OpenAIRE |
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