Development and validation of novel scales to measure trust and confidence in using telephone and video consultation scales in people with chronic kidney disease.

Abstract

AimPatients' trust and confidence in telehealth are core components of its adoption, effectiveness and sustained use. This study aimed to develop and validate scales to measure trust and confidence in using telephone and video consultations in people with chronic kidney disease (CKD).MethodsAfter developing potential items, two-phases were conducted to investigate construct validity. Phase 1 examined face and content validity via: think-aloud patients focus group (n = 5), specialists email feedback (n = 3) and telehealth investigators group discussion (n = 4). Phase 2 used factor analytical methods to evaluate structural validity and internal consistency reliability after surveying a sample of people with CKD at an Australian metropolitan hospital. Four exploratory factor analyses (EFA) with oblique rotation Promax were conducted. Parallel analysis was used for factor retention and items with factor loadings ≥0.60 on the primary factor and without substantive cross-loadings were maintained. Cronbach's alpha (α) measured the internal consistency reliability.ResultsPhase 1 resulted in 17 items to measure trust in telephone consultations, 17 items to measure trust in video consultations, 8 items to measure confidence in using telephone consultations and 8 items to measure confidence in using video consultations (total 50 items). Phase 2: EFA results (N = 156) for the trust scales were both unidimensional: (1) 12-item trust in telephone consultations (α = 0.92); (2) 12-item trust in video consultations (α = 0.93). EFA resulted in two factors for each of the confidence scales: (3) Confidence in using telephone consultations (α = 0.82), comprising 4-item 'competence & capability' factor (α = 0.84) and 3-item 'social & technical support' factor (α = 0.82); (4) Confidence in using video consultations (α = 0.84) comprising 4-item experience 'competence & capability' factor (α = 0.84) and 3-item 'social & technical support' factor (α = 0.82). Internal consistency reliability of all scales and subscales were adequate (α > 0.80).ConclusionOur study demonstrated excellent psychometric properties of the TCTVC scales, which can be reliably used across broader cohorts.