Development and Psychometric Testing of EPAT-16: A Short and Valid Measure for Patient-Centeredness From the Patient's Perspective

IF 3 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Health Expectations Pub Date : 2025-05-20 DOI:10.1111/hex.70296

Eva Christalle, Levente Kriston, Stefan Zeh, Hannah Führes, Alica Schellhorn, Pola Hahlweg, Jördis Maria Zill, Martin Härter, Isabelle Scholl

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Abstract

Background

We previously developed the EPAT-64, a patient-reported experience measure designed to assess patient-centeredness (PC) across 16 dimensions of the validated integrative model of PC. While its modular structure makes it highly adaptable to examine certain dimensions of PC, generating an overall PC score requires assessing all 64 items. This is often challenging in routine settings with limited resources. Therefore, we developed and psychometrically tested a 16-item short form.

Methods

We conducted a cross-sectional study involving adult inpatients and outpatients receiving treatment for cardiovascular diseases, cancer, musculoskeletal disorders and mental health conditions in Germany. To ensure comprehensive content coverage, we selected one item per dimension based on content relevance as well as item characteristics such as item difficulty and item-total correlation. We assessed the structural validity of a unidimensional model using confirmatory factor analysis (CFA), measured reliability with McDonald's Omega and evaluated construct validity by investigating the intercorrelation of the EPAT-16 sum score with measures of general health status and satisfaction with care.

Results

All items of the final EPAT-16 showed high acceptability and good item-total correlations, with approximately two-thirds demonstrating appropriate item difficulty. CFA showed a slight misfit of the unidimensional model, but a high average variance explained. McDonald's Omega showed high reliability. All hypotheses about construct validity were confirmed.

Conclusions

The EPAT-16 demonstrated good psychometric properties, making it a feasible tool for assessing overall PC when resource constraints preclude using the full EPAT-64. In particular, it can be used in routine care for feedback and quality improvement, as well as in research to assess relationships with other relevant variables. Since its items were designed generically, it can be used for different medical conditions and settings, for example for public reporting. Future research should evaluate the EPAT-16 in diverse, independent patient samples to confirm that its positive characteristics are consistent across different populations and cultures.

Patient or Public Contribution

Patients did not participate as active members of the research team. However, for the research proposal, several patient organizations provided positive feedback on the study aims and their relevance, signed a collaboration agreement and later supported recruitment by distributing study information.

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EPAT-16的开发和心理测量测试：从患者的角度衡量以患者为中心的一种简短而有效的方法

我们之前开发了EPAT-64，这是一种患者报告的体验测量，旨在从16个维度评估以患者为中心（PC）的验证整合模型。虽然它的模块化结构使其高度适应于检查PC的某些维度，但生成PC的总体得分需要评估所有64项。在资源有限的常规环境中，这通常具有挑战性。因此，我们开发了一个包含16个项目的简短表格，并进行了心理测量学测试。方法我们进行了一项横断面研究，涉及在德国接受心血管疾病、癌症、肌肉骨骼疾病和精神健康状况治疗的成年住院患者和门诊患者。为了确保全面的内容覆盖，我们根据内容相关性以及项目特征（如项目难度和项目总相关性）每个维度选择一个项目。我们使用验证性因子分析（CFA）评估一维模型的结构效度，使用McDonald's Omega测量信度，并通过调查EPAT-16总得分与一般健康状况和护理满意度的相互关系来评估结构效度。结果最终EPAT-16的所有项目均表现出较高的可接受性和良好的项目总数相关性，约三分之二的项目显示出适当的项目难度。CFA显示了一维模型的轻微不拟合，但高平均方差解释。麦当劳的Omega显示出高可靠性。所有关于构念效度的假设均得到证实。结论EPAT-16表现出良好的心理测量特性，当资源限制无法使用完整的EPAT-64时，它是评估整体PC的可行工具。特别是，它可以用于常规护理的反馈和质量改进，以及在研究中评估与其他相关变量的关系。由于其项目是通用设计的，因此可以用于不同的医疗条件和设置，例如用于公共报告。未来的研究应在不同、独立的患者样本中评估EPAT-16，以确认其阳性特征在不同人群和文化中是一致的。患者没有作为研究团队的积极成员参与。然而，对于研究计划，几个患者组织对研究目的及其相关性提供了积极的反馈，签署了合作协议，并随后通过分发研究信息来支持招募。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Health Expectations 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.20

自引率

9.40%

发文量

251

审稿时长

>12 weeks

期刊介绍： Health Expectations promotes critical thinking and informed debate about all aspects of patient and public involvement and engagement (PPIE) in health and social care, health policy and health services research including: • Person-centred care and quality improvement • Patients'' participation in decisions about disease prevention and management • Public perceptions of health services • Citizen involvement in health care policy making and priority-setting • Methods for monitoring and evaluating participation • Empowerment and consumerism • Patients'' role in safety and quality • Patient and public role in health services research • Co-production (researchers working with patients and the public) of research, health care and policy Health Expectations is a quarterly, peer-reviewed journal publishing original research, review articles and critical commentaries. It includes papers which clarify concepts, develop theories, and critically analyse and evaluate specific policies and practices. The Journal provides an inter-disciplinary and international forum in which researchers (including PPIE researchers) from a range of backgrounds and expertise can present their work to other researchers, policy-makers, health care professionals, managers, patients and consumer advocates.