1. Validation of the Rainbow Model of Integrated Care Measurement Tools (RMIC-MTs) in renal care for patient and care providers
- Author
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Giovanni F.M. Strippoli, Pim Valentijn, Hubertus J. M. Vrijhoef, Dirk Ruwaard, Fernando Pereira, Jörgen Hegbrant, Christina W. Sterner, RS: CAPHRI School for Public Health and Primary Care, Health Services Research, and RS: CAPHRI - R2 - Creating Value-Based Health Care
- Subjects
Questionnaires ,Male ,Research Validity ,Health Personnel/statistics & numerical data ,Culture ,CONTINUITY ,Social Sciences ,Pilot Projects ,Kidney ,Ambulatory Care Facilities ,0302 clinical medicine ,Mathematical and Statistical Techniques ,Sociology ,Surveys and Questionnaires ,Health care ,Chronic Kidney Disease ,80 and over ,Content validity ,Medicine and Health Sciences ,Medicine ,Outpatient clinic ,Psychology ,Renal Insufficiency ,030212 general & internal medicine ,Child ,Integrated/methods ,Aged, 80 and over ,OUTCOMES ,Multidisciplinary ,Delivery of Health Care, Integrated ,030503 health policy & services ,Statistics ,Research Assessment ,Middle Aged ,DEPRESSION ,Exploratory factor analysis ,Nephrology ,Research Design ,DISEASE-MANAGEMENT PROGRAMS ,Child, Preschool ,Physical Sciences ,HEART-FAILURE ,Female ,0305 other medical science ,Surveys and Questionnaires/statistics & numerical data ,Factor Analysis ,Kidney/physiopathology ,Research Article ,Predictive validity ,Adult ,Psychometrics ,Adolescent ,Science ,Health Personnel ,Renal Insufficiency, Chronic/physiopathology ,Research and Analysis Methods ,03 medical and health sciences ,Young Adult ,Delivery of Health Care, Integrated/methods ,Nursing ,Cronbach's alpha ,Medical Dialysis ,QUALITY ,Humans ,Statistical Methods ,Renal Insufficiency, Chronic ,Preschool ,Psychometrics/statistics & numerical data ,METAANALYSIS ,Aged ,Chronic/physiopathology ,Survey Research ,business.industry ,Construct validity ,Biology and Life Sciences ,Reproducibility of Results ,Eigenvalues ,Integrated care ,Ambulatory Care Facilities/statistics & numerical data ,Algebra ,Cross-Sectional Studies ,Linear Algebra ,HEALTH-CARE ,business ,Delivery of Health Care ,Mathematics - Abstract
INTRODUCTION: Integrated service delivery is considered to be an essential condition for improving the management and health outcomes of people with chronic kidney disease (CKD). However, research on the assessment of integrated care by patients and care providers is hindered by the absence of brief, reliable, and valid measurement tools.OBJECTIVE: The aim of this study was to develop survey instruments for healthcare professionals and patients based on the Rainbow Model of Integrated Care (RMIC), and to evaluate their psychometric properties.DESIGN: The development process was based on the US Food and Drug Administration guidelines. This included item generation from systematic reviews of existing tools and expert opinion on clarity and content validity, involving renal care providers and chronic kidney patients. A cross-sectional, multi-centre design was used to test for internal consistency and construct validity.SETTING: Outpatient clinics in a large renal network.PARTICIPANTS: A sample of 30.788 CKD patients, and 8.914 renal care providers.METHODS AND ANALYSIS: Both survey instruments were developed using previous qualitative work and published literature. A multidisciplinary expert panel assessed the face and content validity of both instruments and following a pilot study, the psychometric properties of both instruments were explored. Exploratory factor analysis with principal axis factoring and with promax rotation was used to assess the underlying dimensions of both instruments; Cronbach's alpha was used to determine the internal constancy reliability.RESULTS: 17.512 patients (response rate: 56.9%) and 8.849 care providers (response rate: 69.5%) responded to the questionnaires. Factor analysis of the patient questionnaire yielded three internally consistent (Cronbach's alpha > 0.7) factors: person-centeredness, clinical coordination, and professional coordination. Factor analysis of the provider questionnaire produced eight internally consistent (Cronbach's alpha > 0.7) factors: person-centeredness, community centeredness, clinical coordination, professional coordination, organisational coordination, system coordination, technical and cultural competence. As hypothesised, care coordination patient and providers scores significantly correlated with questions about quality of care, treatment involvement, reported health, clinics' organisational readiness, and external care coordination capacity.CONCLUSION: This study provides evidence for the reliability and validity of the RMIC patient and provider questionnaires as generic tools to assess the experience with or perception of integrated renal care delivery. The instruments are recommended in future applications testing test-retest reliability, convergent and predictive validity, and responsiveness.
- Published
- 2019