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Patients' assessment of chronic illness care: a validation study among patients with type 2 diabetes in Finland
Folkhälsan Research Center, Helsinki, Finland / Department of Public Health, University of Helsinki, Helsinki, Finland.ORCID iD: 0000-0003-1376-7588
Folkhälsan Research Center, Helsinki, Finland / Department of Public Health, University of Helsinki, Helsinki, Finland.
University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Public Health, University of Turku, Turku, Finland. (Individ och samhälle, Individual and Society (VIDSOC))ORCID iD: 0000-0001-6648-603X
2018 (English)In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 18, article id 412Article in journal (Refereed) Published
Abstract [en]

Background: To meet the challenges of the rising prevalence of chronic diseases, such as type 2 diabetes, new approaches to healthcare delivery have been initiated; among these the influential Chronic Care Model (CCM). Valid instruments are needed to evaluate the public health impact of these frameworks in different countries. The Patient Assessment of Chronic Illness Care (PACIC) is a 20-item quality of care measure that, from the perspective of the patient, measures the extent to which care is congruent with the CCM. The aim of this study was to evaluate the psychometric properties of the Finnish translation of the PACIC questionnaire, in terms of validity and reliability, in a large register-based sample of patients with type 2 diabetes.

Method: The PACIC items were translated into Finnish in a standardized forward-backward procedure, followed by a cross-sectional survey among patients with type 2 diabetes (response rate 56%; n = 2866). We assessed the Finnish version of the PACIC scale for the following psychometric properties: content validity, internal consistency reliability, convergent and construct validity. We also present descriptive data on total scale as well as predetermined subscale levels.

Results: The item-response on the PACIC scale was high with only small numbers of missing data (0.5-1.1%). Ceiling effects were low (0.3-5.3%) whereas floor effects were over 20% for two of the predetermined subscales (problem solving and follow-up/coordination). The total PACIC scale showed a reasonable distribution and excellent internal consistency (alpha 0.94) while the internal consistency of the subscales were at least acceptable (0.74-0.86). The principal component analysis identified a two-or three-factor solution instead of the proposed five-dimensional. In other respects, the PACIC scale showed the hypothesized relationships with quality of care and outcome measures, thus demonstrating convergent and construct validity.

Conclusion: A Finnish version of the PACIC scale is now validated in the primary care setting among patients with type 2 diabetes. The findings suggest comparable psychometric properties of the Finnish scale as of the original English instrument and earlier translations, and reasonable levels of validity and reliability.

Place, publisher, year, edition, pages
BioMed Central, 2018. Vol. 18, article id 412
Keywords [en]
Chronic care model, PACIC, Primary care, Quality of care, Type 2 diabetes, Validation
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Individual and Society VIDSOC
Identifiers
URN: urn:nbn:se:his:diva-16010DOI: 10.1186/s12913-018-3206-7ISI: 000434285400006PubMedID: 29871638Scopus ID: 2-s2.0-85048073148OAI: oai:DiVA.org:his-16010DiVA, id: diva2:1234100
Available from: 2018-07-23 Created: 2018-07-23 Last updated: 2018-10-23Bibliographically approved

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Suominen, Sakari

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CiteExportLink to record
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