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Zarza-Arribas M, Menárguez Puche JF, Morales López R, Barber Valles JX, Orozco Beltrán DL. Cross-Cultural Adaptation and Validation of the Perception of the Doctor-Patient Relationship (PREMEPA) Questionnaire in Chronic Multi-Pathological Patients. J Prim Care Community Health 2024; 15:21501319241241198. [PMID: 38554060 PMCID: PMC10981856 DOI: 10.1177/21501319241241198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 03/01/2024] [Accepted: 03/05/2024] [Indexed: 04/01/2024] Open
Abstract
OBJECTIVE To conduct a cross-cultural adaptation and validation in Primary Care of the PREMEPA doctor-patient relationship perception questionnaire. DESIGN Descriptive, cross-sectional study, using self-administered questionnaires. Qualitative validation: an adapted version of the original questionnaire, was adapted to our culture. The process consisted of the evaluation, cross-cultural adaptation and consensus of a group of experts. The questionnaire was piloted on a sample of 32 patients diagnosed with at least 2 chronic pathologies. MEASURES Cognitive piloting, comprehensibility assessment, content validation and internal consistency analysis using Cronbach's alpha coefficient. Quantitative validation: the internal consistency, construct validity and validity of the questionnaire were studied by means of a confirmatory factor analysis developed in a multicenter study, randomly selecting 202 patients with at least 2 chronic pathologies. RESULTS Content validity of the new Spanish version was confirmed to be adequate. Comprehensibility and internal consistency (Cronbach's α coefficient = 0.78) were adequate. The confirmatory factor analysis showed good dimensionality, factor relationship and internal consistency, as well as acceptable construct validity. The final result was a 13-item questionnaire consisting of 2 dimensions, which explain 58.5% of the variance: participation in decision-making (accounting for 45.2% of the variance) and person-centered communication (encompassing courtesy, empathy, humanity, and trust). CONCLUSIONS This adapted version of the PREMEPA questionnaire can be considered valid for use in the Spanish population with a history of chronic pathology. This version of PREMEPA provides a new instrument to understand and improve chronic patient care, which can improve the doctor-patient relationship, encouraging adherence to treatment and enhancing health outcomes.
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Therapeutic alliance impact on analgesic outcomes in a real-world clinical setting: An observational study. ACTA PHARMACEUTICA (ZAGREB, CROATIA) 2022; 72:529-545. [PMID: 36651362 DOI: 10.2478/acph-2022-0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/19/2022] [Indexed: 01/20/2023]
Abstract
A good therapeutic alliance is relevant for healthcare providers exposed to patients' suffering, especially since patients and physicians may understand the painful experience differently. Our aim was to explore the impact of therapeutic alliance on analgesic outcomes in a real-world interdisciplinary pain unit (PU). A cross-sectional observational study was conducted on outpatients (n = 69) using opioids on a long-term basis for the treatment of chronic non-cancer pain, where clinical pharmacologists and pharmacists advised patients about their opioid treatment. Responses to the patient-doctor relationship questionnaire (PDRQ), sociodemographic and clinical information (pain level, quality of life and hospital use) were collected, whereas pharmacology data (analgesic prescription, adverse events, and compliance) were obtained from electronic health records. Patients were predominantly middle-aged (75 % women, 72 % retired), experiencing moderate pain (VAS 40-70 mm) on average, and under a high morphine equianalgesic dosage (95 ± 88 mg per day, mainly tapentadol or fentanyl). Patients with better PDRQ outcomes, and therefore better therapeutic alliance, showed lower pain intensity than patients with worse PDRQ outcomes (pain intensity: high scores 60 ± 47 mm and medium scores 60 ± 45 mm vs. low scores 80 ± 75 mm, p < 0.01). Along with this, pain intensity was lower when patients affirmed that, thanks to the health-care providers, they "gained new insight", "felt better", or "felt content with their doctor's treatment". What´s more, patients who affirmed "I benefit from the treatment" experienced increased pain relief (benefit 40 ± 30 vs. non-benefit 19 ± 26 mm, p = 0.010) and improved quality of life (benefit 33 ± 25 vs. non-benefit 18 ± 16 mm, p = 0.031). However, there was a percentage of patients who did not fully understand the provided information, which is something to be taken into account to improve in clinical routine. Therapeutic alliance supported by pharmacist experts on pain management can be an effective strategy to improve analgesic outcomes. Further efforts are needed to improve communication strategies for pain management. Future directions of research should include the analysis of the role of the pharmacist in poly-professional consultations as related to the advice of patients about their medication, and the mutual trust with the patients.
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du Baret de Limé M, Monin J, Leschiera J, Duquet J, Manen O, Chiniard T. Self-Medication Among Military Fighter Aircrews. Aerosp Med Hum Perform 2022; 93:571-580. [DOI: 10.3357/amhp.5998.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND: The practice of self-medication among military fighter aircrew could compromise flight safety because of the adverse effects that can occur in flight. However, data on this subject is scarce. The aim of this study was to identify the determinants of the practice in
this population.METHODS: A cross-sectional study was carried out among the French Air Force fighter aircrew based on an anonymous questionnaire distributed electronically. The questions included personal characteristics, opinions, and relations with the healthcare domain as well
as the use of self-medication in general and before a flight.RESULTS: Between March and November 2020, 170 questionnaires were reviewed for an overall return rate of approximately 34%. Our data showed an absolute self-medication rate of 97.6%, but the frequency of its use was rare
or nonexistent in 53.5% of cases. Factors associated with a more frequent use of self-medication were the function of pilot, age under 35, having a regular prescription, lacking intentionality toward getting enough sleep, having confidence in the medical profession, and some specific clinical
situations. The consumption of 97 medications was recorded and 49 before a flight.DISCUSSION: Despite the limitations due to the design of this survey, results suggest that the use of self-medication in fighter aircrews is a reality, but that the frequency of its use is less common.
This practice is probably the result of a complex interaction between many personal factors. However, its impact on flight safety remains uncertain.du Baret de Limé M, Monin J, Leschiera J, Duquet J, Manen O, Chiniard T. Self-medication among military fighter aircrews.
Aerosp Med Hum Perform. 2022; 93(7):571–580.
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Sarabia-Tapia C, Corona T, Lopez-Alamillo S, Resendiz-Henriquez E, Cervantes-Arriaga A, Rodríguez-Violante M. Independence of Coping Styles With the Patient-Doctor Relationship and Shared Decision-Making in People With Parkinson's Disease. J Patient Exp 2021; 7:1271-1277. [PMID: 33457575 PMCID: PMC7786658 DOI: 10.1177/2374373520918725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Introduction: Coping styles have a mediating effect on several clinical outcomes. The patient–doctor relationship and the patient’s role in decision-making process might be influenced by the way the patient reacts to certain stressors or problems due to the evolution of their disease. Objective: To assess the role of coping strategies on the patient–doctor relationship and the patient’s role in decision-making in a group of people with Parkinson’s disease (PD). Methods: A cross-sectional study was carried out. The Coping Style Questionnaire (CSQ-40), the 9-item Patient–Doctor Relationship Questionnaire (PDRQ-9), and the 9-item Shared Decision-Making Questionnaire (SDM-Q-9) were applied. Results: A total of 36 women and 64 men with PD were included. The predominant coping style in women was rational. In men, the detachment style was more frequent. The SDM-Q-9 mean score was 33.2 ± 11.2 (transformed median score of 80). The PDRQ-9 average score was 2.9 ± 1 (sum score of 26.1 ± 8.7). No association was found between the CSQ-40 with the PDRQ-9 or SDM-Q-9. On the other hand, the PDRQ-9 mean score and the transformed SDM-Q-9 score highly correlated (r = 0.62, P < .001). Conclusion: Patient–doctor relationship and shared decision-making are independent of the coping style in people with PD.
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Affiliation(s)
- Cynthia Sarabia-Tapia
- Clinical Neurodegenerative Research Unit, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
| | - Teresa Corona
- Clinical Neurodegenerative Research Unit, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
| | - Susana Lopez-Alamillo
- Clinical Neurodegenerative Research Unit, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
| | - Etienne Resendiz-Henriquez
- Clinical Neurodegenerative Research Unit, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
| | - Amin Cervantes-Arriaga
- Clinical Neurodegenerative Research Unit, National Institute of Neurology and Neurosurgery, Mexico City, Mexico.,Movement Disorder Clinic, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
| | - Mayela Rodríguez-Violante
- Clinical Neurodegenerative Research Unit, National Institute of Neurology and Neurosurgery, Mexico City, Mexico.,Movement Disorder Clinic, National Institute of Neurology and Neurosurgery, Mexico City, Mexico
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Pascual-Ramos V, Contreras-Yáñez I, Ortiz-Haro AB, Albert CM, Obrador GT, Agazzi E. Concordance among patients and physicians about their ideal of autonomy impacts the patient-doctor relationship: A cross-sectional study of Mexican patients with rheumatic diseases. PLoS One 2020; 15:e0240897. [PMID: 33119715 PMCID: PMC7595407 DOI: 10.1371/journal.pone.0240897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 10/05/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION In patient-doctor interaction both parties play a role. Primary objective was to determine if the concordance among rheumatologists and their patients of their ideal of autonomy was associated with a better patient-doctor relationship. Secondary objective was to describe factors associated to a patient paternalistic ideal of autonomy (PPIA). MATERIALS AND METHODS This cross-sectional study had 3 steps. Step-1 consisted in translation/cultural local adaption of Ideal Patient Autonomy Scale (IPAS), a 14-items Dutch questionnaire. Step-2 consisted of IPAS validity and reliability in 201 outpatients. Step-3 consisted of the application of IPAS and the patient-doctor relationship questionnaire (PDRQ) to 601 outpatients with a medical encounter, and of IPAS to the 21 attending rheumatologists. Each patient-physician encounter was classified into with/without concordance in the ideal of autonomy and PRDQ scores were compared (Man Whitney U test). Regression analysis was used for associations. RESULTS Step-1 followed ISPOR task force recommendations. Patients from Step-2 and Step-3 were representative outpatients with rheumatic diseases. IPAS structure underwent a modification; the 14 items were redistributed into four subscales, further combined into PPIA vs. patient-centered autonomy ideal. IPAS was valid and reliable. There were 497 patients with a preferred ideal of autonomy, primarily (84.9%) PPIA. There were 363 patient-doctor encounters with concordance in the autonomy ideal and their PDRQ-9 scores were higher. Religious beliefs and higher PDRQ-9 item 8 score ("I feel pleased with my doctor´s treatment") were associated to a PPIA. CONCLUSIONS Concordance of autonomy ideal among patients and their rheumatologists positively impacts on the patient-doctor relationship.
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Affiliation(s)
- Virginia Pascual-Ramos
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico, Mexico
| | - Irazú Contreras-Yáñez
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico, Mexico
| | - Ana Belén Ortiz-Haro
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico, Mexico
| | | | - Gregorio Tomás Obrador
- Universidad Panamericana, Interdisciplinary Center of Bioethics and School of Medicine, Mexico, Mexico
| | - Evandro Agazzi
- Universidad Panamericana Interdisciplinary Center of Bioethics, Mexico, Mexico
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Pascual López JA, Gil Pérez T, Sánchez Sánchez JA, Menárguez Puche JF. [Questionnaires of person centered care in primary care. A systematic review]. Aten Primaria 2019; 52:738-749. [PMID: 31883783 PMCID: PMC8054285 DOI: 10.1016/j.aprim.2019.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 10/11/2019] [Accepted: 11/18/2019] [Indexed: 12/30/2022] Open
Abstract
Objetivo Pese a la importancia de la «atención centrada en la persona» (ACP), hay evidentes limitaciones para valorarla y medirla, debidas probablemente a la dificultad para definirla. El objetivo del estudio fue identificar herramientas validadas que midiesen la ACP o algunos de sus aspectos en el ámbito de la atención primaria. Diseño Revisión sistemática. Fuentes de datos MEDLINE, Embase, Cochrane, PSYCinfo, IME-Biomedicina, LILACS y TESEO hasta del 31 de mayo de 2018. Selección de estudios Los criterios de inclusión fueron: a) estudios de validación de cuestionarios, revisiones sistemáticas sobre estudios de validación u otros estudios descriptivos, b) realizados todos ellos en el ámbito de la atención primaria y c) que midieran aspectos de la ACP en profesionales y/o pacientes. Dos investigadores revisaron de forma independiente los artículos y sus discrepancias fueron resueltas por un tercer investigador. Extracción de datos Se recogieron datos sobre los aspectos de la ACP medidos, población a la que se dirige, tipo de cuestionario, y datos sobre validez y fiabilidad. Resultados Se localizaron 1.415 artículos a los que se añadieron 54 referencias adicionales identificadas a través de referencias de los artículos de la revisión sistemática. Tras una depuración finalmente fueron 75 los artículos que cumplieron todos los criterios y 39 las herramientas identificadas y clasificadas según las dimensiones analizadas. Conclusiones Debido a la dificultad de medir la ACP en su conjunto, la mayor parte de los artículos hacen referencia solo a alguno de sus aspectos o dimensiones, predominando la perspectiva del paciente frente a la del profesional. Estas herramientas son, no obstante, un importante punto de partida para futuros cuestionarios que intenten valorar de forma integral la ACP.
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Affiliation(s)
| | - Trinidad Gil Pérez
- Centro de Salud docente Mariano Yago, Servicio Murciano de Salud, Yecla, Murcia, España
| | - Juan Antonio Sánchez Sánchez
- Grupo de Trabajo de Medicina Basada en la Evidencia, Sociedad Murciana de Medicina de Familia y Comunitaria (SMUMFyC), Murcia, España
| | - Juan Francisco Menárguez Puche
- Grupo de Trabajo de Medicina Basada en la Evidencia, Sociedad Murciana de Medicina de Familia y Comunitaria (SMUMFyC), Murcia, España; Centro de Salud docente Profesor Jesús Marín, Molina de Segura, Murcia, España
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Arias Fernández L, Pardo Seco J, Cebey-López M, Gil Prieto R, Rivero-Calle I, Martinon-Torres F, Gil de Miguel Á, Martinón-Torres F, Vargas D, Mascarós E, Redondo E, Díaz-Maroto JL, Linares-Rufo M, Gil A, Molina J, Ocaña D, Rivero-Calle I. Differences between diabetic and non-diabetic patients with community-acquired pneumonia in primary care in Spain. BMC Infect Dis 2019; 19:973. [PMID: 31730464 PMCID: PMC6858692 DOI: 10.1186/s12879-019-4534-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Accepted: 10/09/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Diabetes is one of the underlying risk factors for developing community-acquired pneumonia (CAP). The high prevalence of diabetes among population and the rising incidence of this illness, converts it as an important disease to better control and manage, to prevent its secondary consequences as CAP. The objective of this research is to describe the characteristics of the patients with diabetes and the differences with the no diabetes who have had an episode of CAP in the context of the primary care field. METHODS A retrospective, observational study in adult patients (> 18 years-old) who suffer from CAP and attended at primary care in Spain between 2009 and 2013 was developed using the Computerized Database for Pharmacoepidemiological Studies in Primary Care (BIFAP). We carried out a descriptive analysis of the first episodes of CAP, in patients with or without diabetes as comorbidity. Other morbidity (CVA, Anaemia, Arthritis, Asthma, Heart disease, Dementia, Depression, Dysphagia, Multiple sclerosis, Epilepsy, COPD, Liver disease, Arthrosis, Parkinson's disease, Kidney disease, HIV) and life-style factors were also included in the study. RESULTS A total of 51,185 patients were included in the study as they suffer from the first episode of CAP. Of these, 8012 had diabetes as comorbidity. There were differences between sex and age in patients with diabetes. Patients without diabetes were younger, and had less comorbidities including those related to lifestyles such as smoking, alcoholism, social and dental problems than patients with diabetes. CONCLUSIONS Patients who developed an episode of CAP with diabetes have more risk factors which could be reduced with an appropriate intervention, including vaccination to prevent successive CAP episodes and hospitalization. The burden of associated factors in these patients can produce an accumulation of risk. Health care professional should know this for treating and control these patients in order to avoid complications. Diabetes and those other risk factors associated could be reduced with an appropriate intervention, including vaccination to prevent the first and successive CAP episodes and the subsequent hospitalization in severe cases.
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Affiliation(s)
- Loreto Arias Fernández
- Epidemiology of Infectious Diseases, Rey Juan Carlos University, Avda. Atenas s/n, CP, 28922 Alcorcón, Madrid Spain
| | - Jacobo Pardo Seco
- Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Spa Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
| | - Miriam Cebey-López
- Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Spa Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
| | - Ruth Gil Prieto
- Area of Preventive Medicine & Public Health, Rey Juan Carlos University, Madrid, Spain
| | - Irene Rivero-Calle
- Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Spa Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
| | - Federico Martinon-Torres
- Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Spa Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
| | - Ángel Gil de Miguel
- Spa Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
| | - on behalf of NEUMOEXPERTOS group
- Epidemiology of Infectious Diseases, Rey Juan Carlos University, Avda. Atenas s/n, CP, 28922 Alcorcón, Madrid Spain
- Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Spa Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Area of Preventive Medicine & Public Health, Rey Juan Carlos University, Madrid, Spain
| | - F. Martinón-Torres
- Epidemiology of Infectious Diseases, Rey Juan Carlos University, Avda. Atenas s/n, CP, 28922 Alcorcón, Madrid Spain
- Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Spa Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Area of Preventive Medicine & Public Health, Rey Juan Carlos University, Madrid, Spain
| | - D. Vargas
- Epidemiology of Infectious Diseases, Rey Juan Carlos University, Avda. Atenas s/n, CP, 28922 Alcorcón, Madrid Spain
- Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Spa Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Area of Preventive Medicine & Public Health, Rey Juan Carlos University, Madrid, Spain
| | - E. Mascarós
- Epidemiology of Infectious Diseases, Rey Juan Carlos University, Avda. Atenas s/n, CP, 28922 Alcorcón, Madrid Spain
- Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Spa Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Area of Preventive Medicine & Public Health, Rey Juan Carlos University, Madrid, Spain
| | - E. Redondo
- Epidemiology of Infectious Diseases, Rey Juan Carlos University, Avda. Atenas s/n, CP, 28922 Alcorcón, Madrid Spain
- Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Spa Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Area of Preventive Medicine & Public Health, Rey Juan Carlos University, Madrid, Spain
| | - J. L. Díaz-Maroto
- Epidemiology of Infectious Diseases, Rey Juan Carlos University, Avda. Atenas s/n, CP, 28922 Alcorcón, Madrid Spain
- Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Spa Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Area of Preventive Medicine & Public Health, Rey Juan Carlos University, Madrid, Spain
| | - M. Linares-Rufo
- Epidemiology of Infectious Diseases, Rey Juan Carlos University, Avda. Atenas s/n, CP, 28922 Alcorcón, Madrid Spain
- Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Spa Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Area of Preventive Medicine & Public Health, Rey Juan Carlos University, Madrid, Spain
| | - A. Gil
- Epidemiology of Infectious Diseases, Rey Juan Carlos University, Avda. Atenas s/n, CP, 28922 Alcorcón, Madrid Spain
- Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Spa Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Area of Preventive Medicine & Public Health, Rey Juan Carlos University, Madrid, Spain
| | - J. Molina
- Epidemiology of Infectious Diseases, Rey Juan Carlos University, Avda. Atenas s/n, CP, 28922 Alcorcón, Madrid Spain
- Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Spa Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Area of Preventive Medicine & Public Health, Rey Juan Carlos University, Madrid, Spain
| | - D. Ocaña
- Epidemiology of Infectious Diseases, Rey Juan Carlos University, Avda. Atenas s/n, CP, 28922 Alcorcón, Madrid Spain
- Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Spa Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Area of Preventive Medicine & Public Health, Rey Juan Carlos University, Madrid, Spain
| | - I. Rivero-Calle
- Epidemiology of Infectious Diseases, Rey Juan Carlos University, Avda. Atenas s/n, CP, 28922 Alcorcón, Madrid Spain
- Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Spa Genetics, Vaccines, Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain
- Area of Preventive Medicine & Public Health, Rey Juan Carlos University, Madrid, Spain
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Wollmann L, Hauser L, Mengue SS, Agostinho MR, Roman R, Van Der Feltz-Cornelis CM, Harzheim E. Cross-cultural adaptation of the Patient-Doctor Relationship Questionnaire (PDRQ-9) in Brazil. Rev Saude Publica 2018; 52:71. [PMID: 30066809 PMCID: PMC6063713 DOI: 10.11606/s1518-8787.2018052000380] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 11/21/2017] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To describe the process of cross-cultural adaptation of the Patient-Doctor Relationship Questionnaire (PDRQ-9), as well as compare the agreement between two different types of application. METHODS This is a cross-sectional study with 133 adult users of a Primary Health Service in Porto Alegre, State of Rio Grande do Sul, Brazil. The PDRQ-9 was answered by the participants as a self-administered questionnaire and in an interview. The instrument was also validated by interview, using data from 628 participants of the Mais Médicos Program Evaluation Research, which is a cross-sectional study with a systematic sample of Primary Care Services in all regions of Brazil. We evaluated the semantic, conceptual, and item equivalence, as well as factor analysis and reliability. RESULTS All items presented factor loading > 0.5 in the different methods of application and populations in the factor analysis. We found Cronbach's alpha of 0.94 in the self-administered method. We found Cronbach's alpha of 0.95 and 0.94 in the two different samples in the interview application. The use of PDRQ-9 with an interview or self-administered was considered equivalent. CONCLUSIONS The cross-cultural adaptation of the PDRQ-9 in Brazil replicated the factorial structure found in the original study, with high internal consistency. The instrument can be used as a new dimension in the evaluation of the quality of health care in clinical research, in the evaluation of services and public health, in health management, and in professional training. Further studies can evaluate other properties of the instrument, as well as its behavior in different populations and contexts.
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Affiliation(s)
- Lucas Wollmann
- Universidade Federal do Rio Grande do Sul. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Porto Alegre, RS, Brasil
| | - Lisiane Hauser
- Universidade Federal do Rio Grande do Sul. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Porto Alegre, RS, Brasil
| | - Sotero Serrate Mengue
- Universidade Federal do Rio Grande do Sul. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Porto Alegre, RS, Brasil
| | - Milena Rodrigues Agostinho
- Universidade Federal do Rio Grande do Sul. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Porto Alegre, RS, Brasil
| | - Rudi Roman
- Universidade Federal do Rio Grande do Sul. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Porto Alegre, RS, Brasil
| | | | - Erno Harzheim
- Universidade Federal do Rio Grande do Sul. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Porto Alegre, RS, Brasil
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Serral G, Puigpinós-Riera R. Cribado mamográfico, ¿qué nos depara el futuro? Med Clin (Barc) 2018; 150:224-225. [DOI: 10.1016/j.medcli.2017.06.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 06/15/2017] [Indexed: 10/19/2022]
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Bermúdez-Román V, Bran-Piedrahita L, Palacios-Moya L, Posada-Zapata IC. [Physician-patient relationship: Impact on promotion and prevention campaigns for patients with HIV in Medellin]. Rev Salud Publica (Bogota) 2018; 18:543-553. [PMID: 28453060 DOI: 10.15446/rsap.v18n4.41665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Accepted: 02/12/2016] [Indexed: 11/09/2022] Open
Abstract
Objective To understand the impact that healthcare professionals have on the perception of health promotion and disease prevention campaigns of individuals with HIV in Medellin, Colombia in 2012. MATERIALS AND METHODS The research was conducted using a qualitative approach, based on the Strauss and Corbin´s Grounded Theory; thirteen people were interviewed during two sequential steps. The interviews were transcribed and analyzed in accordance with the theory mentioned above, by performing an open and axial coding on the data found. Results A total of 1 324 codes were generated in the open coding process (creating six descriptive categories) and axial coding process (identifying four analytical categories; one of them is developed as a result in this paper). The most relevant findings included the importance given by the participants to the role of health professionals when supporting HIV-positive patients in the acquisition of healthy lifestyles to properly manage their condition. Also, the role that those people who already contracted the virus have for the promotion of sexual behaviors to minimize the risk of infection is stated. Conclusion The doctor-patient relationship poses great challenges in terms of health services management for the different actors of the system. Likewise, these challenges must be taken into account when creating future public policies.
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Dinkel A, Schneider A, Schmutzer G, Brähler E, Häuser W. Family physician-patient relationship and frequent attendance of primary and specialist health care: Results from a German population-based cohort study. PATIENT EDUCATION AND COUNSELING 2016; 99:1213-1219. [PMID: 26924610 DOI: 10.1016/j.pec.2016.02.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Revised: 02/09/2016] [Accepted: 02/12/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To investigate the association between the quality of the family physician-patient relationship and frequent attendance of primary and specialist health care. METHODS Cross-sectional survey of a representative German population sample (N=2.266). Family physician-patient relationship was assessed with the Patient Doctor Relationship Questionnaire (PDRQ-9). Determinants of frequent attendance were analyzed using logistic regression. RESULTS Frequent attendance of family physicians was associated with lower income (OR 1.43, 95% CI 1.02-2.00), not being in paid work (OR 1.58, CI 1.08-2.30), psychological distress (OR 1.14, CI 1.07-1.22), somatic symptoms (OR 1.07, CI 1.04-1.11), and physical comorbidity (OR 1.54, CI 1.36-1.74) in the multivariate analysis. Frequent attendance of specialists was related to psychological distress (OR 1.12, CI 1.04-1.20), somatic symptoms (OR 1.08, CI 1.04-1.11), and physical comorbidity (OR 1.69, CI 1.48-1.93) in the multivariate analysis. Quality of the relationship was associated with frequent attendance only in the univariate analyses. A stronger relationship with the family physician was not associated with reduced contact with specialists. CONCLUSIONS The quality of the family physician-patient relationship is not independently associated with frequent attendance. PRACTICE IMPLICATIONS Family physicians should be aware that need factors, i.e. symptom burden and physical comorbidities, are main drivers of frequent attendance.
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Affiliation(s)
- Andreas Dinkel
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
| | - Antonius Schneider
- Institute of General Practice, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
| | - Gabriele Schmutzer
- Department of Medical Psychology and Medical Sociology, Universität Leipzig, Leipzig, Germany.
| | - Elmar Brähler
- Department of Medical Psychology and Medical Sociology, Universität Leipzig, Leipzig, Germany; Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg Universität Mainz, Mainz, Germany.
| | - Winfried Häuser
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; Department of Internal Medicine I, Klinikum Saarbrücken, Saarbrücken, Germany.
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Hoytema van Konijnenburg EMM, Diderich HM, Teeuw AH, Klein Velderman M, Oudesluys-Murphy AM, van der Lee JH. Comparing policies for children of parents attending hospital emergency departments after intimate partner violence, substance abuse or suicide attempt. CHILD ABUSE & NEGLECT 2016; 53:81-94. [PMID: 26718263 DOI: 10.1016/j.chiabu.2015.11.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Revised: 10/25/2015] [Accepted: 11/18/2015] [Indexed: 06/05/2023]
Abstract
To improve identification of child maltreatment, a new policy ('Hague protocol') was implemented in hospitals in The Netherlands, stating that adults attending the hospital emergency department after intimate partner violence, substance abuse or a suicide attempt should be asked whether they care for children. If so, these children are referred to the Reporting Center for Child Abuse and Neglect (RCCAN), for assessment and referrals to support services. An adapted, hospital-based version of this protocol ('Amsterdam protocol') was implemented in another region. Children are identified in the same manner, but, instead of a RCCAN referral, they are referred to the pediatric outpatient department for an assessment, including a physical examination, and referrals to services. We compared results of both protocols to assess how differences between the protocols affect the outcomes on implementation, detection of child maltreatment and referrals to services. Furthermore, we assessed social validity and results of a screening physical examination. We included 212 families from the Amsterdam protocol (cohort study with reports by pediatric staff and parents) and 565 families from the Hague protocol (study of RCCAN records and telephone interviews with parents). We found that the RCCAN identified more maltreatment than pediatric staff (98% versus at least 51%), but referrals to services were similar (82% versus 80% of the total sample) and parents were positive about both interventions. Physical examination revealed signs of maltreatment in 5%. We conclude that, despite the differences, both procedures can serve as suitable methods to identify and refer children at risk for maltreatment.
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Affiliation(s)
- Eva M M Hoytema van Konijnenburg
- Department of Pediatrics, Emma Children's Hospital, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Hester M Diderich
- Emergency Department, Medical Centre Haaglanden, Lijnbaan 32, 2501 CK Den-Haag, The Netherlands
| | - Arianne H Teeuw
- Department of Pediatrics, Emma Children's Hospital, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | | | - Anne Marie Oudesluys-Murphy
- Social Pediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Johanna H van der Lee
- Pediatric Clinical Research Office, Woman-Child Center, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
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[Satisfaction with primary care nursing: use of measurement tools and explanatory factors]. REVISTA DE CALIDAD ASISTENCIAL : ORGANO DE LA SOCIEDAD ESPANOLA DE CALIDAD ASISTENCIAL 2015; 30:86-94. [PMID: 25748498 DOI: 10.1016/j.cali.2015.01.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 01/21/2015] [Accepted: 01/23/2015] [Indexed: 11/22/2022]
Abstract
OBJECTIVES This study aims to assess the psychometric properties of two measurement tools for patient satisfaction with nursing care in Primary Care, the satisfaction level, and the personal and consultation characteristics associated with its variability. METHODS Subjects randomly selected in 23 Health Care centres in the Community of Madrid were included. Satisfaction was measured by means of the AMABLE and Baker questionnaires, in which the psychometric properties were evaluated. Sociodemographic characteristics of the consultations, variables related to health status, and other related to the consultation process were collected. An explanatory model using Generalized Estimating Equations was constructed. RESULTS The 662 subjects expressed a mean satisfaction of 4.95/5 (SD .25) with AMABLE, and 4.83/5 (SD .42) with the Baker questionnaire. AMABLE had a single dimension (Cronbach's alpha .85), and Baker three: professional care (mean 4.76, SD .48 Cronbach's alpha .74), depth of relationship (mean 3.76, SD 1.18, Cronbach's alpha .73), and perceived time (mean 4.42, SD .86, Cronbach's alpha .47). Ageing, a better perception of health status, and appointments arranged by nurses were associated with higher expressed satisfaction. Home care, hospital admissions, delayed consultation, extended family, or high family income were associated with lower satisfaction. CONCLUSIONS Satisfaction with nurse consultations in Primary Care was very high, and varied depending on personal characteristics and on the type of consultation. The assessed tools allowed this outcome to be measured properly.
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Sarría-Santamera A, Prado-Galbarro FJ, Martín-Martínez MA, Carmona R, Gamiño Arroyo AE, Sánchez-Piedra C, Garrido Elustondo S, del Cura González I. [Survival of patients with heart failure in primary care]. Aten Primaria 2014; 47:438-45. [PMID: 25487462 PMCID: PMC6983774 DOI: 10.1016/j.aprim.2014.03.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 03/11/2014] [Accepted: 03/26/2014] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To describe survival of patients with chronic heart failure (HF) followed up in primary care (PC) and analyse the effect of sex, age, clinical and health services factors, and income levels on survival. DESIGN Longitudinal observational study of a retrospective cohort of patients with information extracted from electronic medical records. SETTING PC Area 7 of the Community of Madrid. PARTICIPANTS Patients 24 year and older with at least one visit to PC in 2006. PRINCIPAL MEASUREMENT Incident cases of HF followed up from 2006 to 2010 or until death. Survival analysis with Kaplan-Meier and Cox proportional hazard multivariate regression. RESULTS A total of 3,061 cases were identified in a cohort of 227,984 patients. The survival rate was 65% at 5 years, with 519 patients dying with a median survival of 49 months. Factors associated with increased risk of mortality were, age (HR=1.04, 1.03-1.05), and having a diagnosis of ischemic heart disease (HR=1.45, 1.15- 1.78), or diabetes (HR=1.52, 1.17-1.95). Factors with a significant protective effect were: female sex (HR=0.72, 0.59-0.86), non-pensioner (HR=0.43, 0.23-0.84), having received the influenza vaccine annually (HR=0.01, 0.00-0.06), prescribed lipid-lowering drugs (HR=0.78, 0.61-0.99) or ACE inhibitors (HR=0.73, 0.60-0.88), and blood tests having been requested (HR=0.97, 0.95-1.00), X-rays (HR=0.81, 0.74-0.88), or electrocardiograms (HR=0.90, 0.81-0.99) in PC. CONCLUSIONS Data from patients with HF followed up in PC indicate that their survival is better than that obtained in other countries, supporting the argument of a better evolution of HF in Mediterranean countries.
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Affiliation(s)
- Antonio Sarría-Santamera
- Agencia de Evaluación de Tecnologías Sanitarias, Instituto de Salud Carlos III, Madrid, España; Unidad Docente de Ciencias Sanitarias y Médico Sociales, Universidad de Alcalá, Alcalá de Henares, Madrid, España; Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), España.
| | | | | | - Rocío Carmona
- Agencia de Evaluación de Tecnologías Sanitarias, Instituto de Salud Carlos III, Madrid, España
| | | | | | - Sofía Garrido Elustondo
- Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), España; Unidad de Investigación de Atención Primaria de Madrid, Madrid, España
| | - Isabel del Cura González
- Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), España; Unidad de Investigación de Atención Primaria de Madrid, Madrid, España; Departamento de Medicina Preventiva, Universidad Rey Juan Carlos, Madrid, España
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The Patient–Doctor Relationship Questionnaire (PDRQ-9) in Primary Care: A Validity Study. J Clin Psychol Med Settings 2014; 21:291-6. [DOI: 10.1007/s10880-014-9407-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Zenger M, Schaefert R, van der Feltz-Cornelis C, Brähler E, Häuser W. Validation of the Patient-Doctor-Relationship Questionnaire (PDRQ-9) in a representative cross-sectional German population survey. PLoS One 2014; 9:e91964. [PMID: 24637904 PMCID: PMC3956823 DOI: 10.1371/journal.pone.0091964] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Accepted: 02/16/2014] [Indexed: 11/18/2022] Open
Abstract
The patient-doctor relationship (PDR) as perceived by the patient is an important concept in primary care and psychotherapy. The PDR Questionnaire (PDRQ-9) provides a brief measure of the therapeutic aspects of the PDR in primary care. We assessed the internal and external validity of the German version of the PDRQ-9 in a representative cross-sectional German population survey that included 2,275 persons aged≥14 years who reported consulting with a primary care physician (PCP). The acceptance of the German version of this questionnaire was good. Confirmatory factor analysis demonstrated that the PRDQ-9 was unidimensional. The internal reliability (Cronbach's α) of the total score was .95. The corrected item-total correlations were≥.94. The mean satisfaction index of persons with a probable depressive disorder was lower than that of persons without a probable depressive disorder, indicating good discriminative concurrent criterion validity. The correlation coefficient between satisfaction with PDR and satisfaction with pain therapy was r = .51 in 489 persons who reported chronic pain, indicating good convergent validity. Despite the limitation of low variance in the PDRQ-9 total scores, the results indicate that the German version of the PDRQ-9 is a brief questionnaire with good psychometric properties to assess German patients' perceived therapeutic alliance with PCPs in public health research.
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Affiliation(s)
- Markus Zenger
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
- * E-mail:
| | - Rainer Schaefert
- Department of General Internal Medicine and Psychosomatics, University of Heidelberg, Heidelberg, Germany
| | - Christina van der Feltz-Cornelis
- Tranzo Department, Faculty of Social Sciences of the University of Tilburg, Tilburg; Clinical Center for Body, Mind and Health, Tilburg, The Netherlands
- Trimbos Instituut, Utrecht, The Netherlands
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Winfried Häuser
- Department of Internal Medicine I, Klinikum Saarbrücken, Saarbrücken, Germany
- Department of Psychosomatic Medicine, Technische Universität München, München, Germany
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Serral G, Puigpinós-Riera R, Maydana E, Pons-Vigués M, Borrell C. [Perception of healthcare professionals on the Breast Cancer Screening Programme in Barcelona]. REVISTA DE CALIDAD ASISTENCIAL : ORGANO DE LA SOCIEDAD ESPANOLA DE CALIDAD ASISTENCIAL 2013; 28:244-253. [PMID: 23791127 DOI: 10.1016/j.cali.2013.01.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Revised: 01/25/2013] [Accepted: 01/26/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVE A good communication plan is vital for optimal results in any screening programme. The objective of this study was to assess the knowledge, involvement and opinion of health professionals regarding the Breast Cancer Screening Programme in Barcelona in 2008. MATERIAL AND METHODS A cross-sectional study using an anonymous and self-administered questionnaire. The study population (N = 960) were health professionals from Primary Health-care (PH), Programs for Sexual and Reproductive Health (PSRH), and Community Pharmacies (CP). The dependent variables were: knowledge of the Programme, professional involvement and opinion of the Programme. The independent variables were: sex, age, qualifications, employment status, and health team. A descriptive and bivariate analysis was performed. Using multivariate logistic regression models adjusted for age, an Odds Ratios (OR) were obtained along with the 95% confidence intervals (CI 95%). RESULTS PSRH professionals know the target population better; 80.2% versus 26.1% PH, and 14.0% CP, respectively. Professional involvement was related to the health care team (ORCP/PH: 0.32, CI 95%: 0.22-0.43) being observed more in PH. The opinion on the Programme in reducing breast cancer mortality was similar in the three teams (61.6% PH, 59.3% PSRH, and 56.5% CP). CONCLUSIONS Healthcare professionals are unaware of some aspects of Programme, such as age range or periodicity. There is great professional involvement and belief that the Programme has helped disseminate information and knowledge on the early detection of breast cancer.
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Affiliation(s)
- G Serral
- Servei de Sistemes d'Informació Sanitària, Agència de Salut Pública de Barcelona, Barcelona, España.
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Martín-Fernández J, del Cura-González MI, Rodríguez-Martínez G, Ariza-Cardiel G, Zamora J, Gómez-Gascón T, Polentinos-Castro E, Pérez-Rivas FJ, Domínguez-Bidagor J, Beamud-Lagos M, Tello-Bernabé ME, Conde-López JF, Aguado-Arroyo Ó, Sanz-Bayona MT, Gil-Lacruz AI. Economic valuation of health care services in public health systems: a study about Willingness to Pay (WTP) for nursing consultations. PLoS One 2013; 8:e62840. [PMID: 23626858 PMCID: PMC3633834 DOI: 10.1371/journal.pone.0062840] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Accepted: 03/27/2013] [Indexed: 11/19/2022] Open
Abstract
Background Identifying the economic value assigned by users to a particular health service is of principal interest in planning the service. The aim of this study was to evaluate the perception of economic value of nursing consultation in primary care (PC) by its users. Methods and Results Economic study using contingent valuation methodology. A total of 662 users of nursing consultation from 23 health centers were included. Data on demographic and socioeconomic characteristics, health needs, pattern of usage, and satisfaction with provided service were compiled. The validity of the response was evaluated by an explanatory mixed-effects multilevel model in order to assess the factors associated with the response according to the welfare theory. Response reliability was also evaluated. Subjects included in the study indicated an average Willingness to Pay (WTP) of €14.4 (CI 95%: €13.2–15.5; median €10) and an average Willingness to Accept [Compensation] (WTA) of €20.9 (CI 95%: €19.6–22.2; median €20). Average area income, personal income, consultation duration, home visit, and education level correlated with greater WTP. Women and older subjects showed lower WTP. Fixed parameters explained 8.41% of the residual variability, and response clustering in different health centers explained 4–6% of the total variability. The influence of income on WTP was different in each center. The responses for WTP and WTA in a subgroup of subjects were consistent when reassessed after 2 weeks (intraclass correlation coefficients 0.952 and 0.893, respectively). Conclusions The economic value of nursing services provided within PC in a public health system is clearly perceived by its user. The perception of this value is influenced by socioeconomic and demographic characteristics of the subjects and their environment, and by the unique characteristics of the evaluated service. The method of contingent valuation is useful for making explicit this perception of value of health services.
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Affiliation(s)
- Jesús Martín-Fernández
- Unidad Docente Multiprofesional de Atención Familiar y Comunitaria Oeste. Gerencia de Atención Primaria, Madrid, Spain.
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Nascimento MID, Reichenheim ME, Monteiro GTR. [Dimensional structure of the Brazilian version of the Scale of Satisfaction with Interpersonal Processes of General Medical Care]. CAD SAUDE PUBLICA 2012; 27:2351-63. [PMID: 22218578 DOI: 10.1590/s0102-311x2011001200007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Accepted: 07/12/2011] [Indexed: 11/22/2022] Open
Abstract
The objective of this study was to reassess the dimensional structure of a Brazilian version of the Scale of Satisfaction with Interpersonal Processes of General Medical Care, proposed originally as a one-dimensional instrument. Strict confirmatory factor analysis (CFA) and exploratory factor analysis modeled within a CFA framework (E/CFA) were used to identify the best model. An initial CFA rejected the one-dimensional structure, while an E/CFA suggested a two-dimensional structure. The latter structure was followed by a new CFA, which showed that the model without cross-loading was the most parsimonious, with adequate fit indices (CFI = 0.982 and TLI = 0.988), except for RMSEA (0.062). Although the model achieved convergent validity, discriminant validity was questionable, with the square-root of the mean variance extracted from dimension 1 estimates falling below the respective factor correlation. According to these results, there is not sufficient evidence to recommend the immediate use of the instrument, and further studies are needed for a more in-depth analysis of the postulated structures.
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Affiliation(s)
- Maria Isabel do Nascimento
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rua Leopoldo Bulhões 1480, Rio de Janeiro, RJ, Brazil.
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