Cross-cultural adaptation of the Moroccan Arabic dialect version of the Primary Care Assessment Tool

OBJECTIVE

To adapt the Primary Primary Care Assessment Tool-Adult Edition into the Moroccan Arabic dialect and to assess its reliability and validity from the perspective of Moroccan adult patients.

METHOD

A committee of experts carried out the cross-cultural adaptation of the Primary Care Assessment Tool. The adapted questionnaire was subject to forward and backward translation and a pilot study. Exploratory factor analysis assessed the internal consistency, reliability, and construct validity of items and scales. Finally, descriptive statistics were performed on the final factor structure.

RESULTS

A 43-item Moroccan Arabic dialect version of the Primary Care Assessment Tool-Adult Edition was developed. It consisted of six multi-item scales that represented the four main dimensions of primary care: first contact, continuity, comprehensiveness, and coordination. Four derived dimensions were included: cultural competence, communication, advice, and community orientation. All six scales demonstrated robust internal consistency, item-total solid correlations, and construct validity. The calculated Cronbach's alpha coefficients ranged from 0.78 to 0.90.

CONCLUSIONS

Comprehensive metric analyses supported the reliability and validity of the Moroccan Arabic dialect version of the Primary Care Assessment Tool-Adult Edition in assessing core primary care domains from the patients' experience. This tool could be used for future research on primary care in Morocco.

Renunciations in forefoot surgery. Critical analysis of surgical waiting lists

INTRODUCTION

The high prevalence of forefoot pathology generates long surgical waiting lists (SWL). We have detected a considerable number of patients who withdraw surgery, which creates an important distortion in our activity and high expenditure of resources. Our objective is to study the factors related to these resignations, as well as, compare them with other pathologies of high prevalence and ambulatory surgical treatment: carpal tunnel syndrome (CTS) and internal meniscopathy (IM).

MATERIAL AND METHODS

Retrospective study of the surgical cancellations on 2,399 patients included in the SWL of the Foot and Ankle Unit of our center for forefoot surgery, between January/2014 and March/2018, both included.

RESULTS

We have found 389 renunciations, which represent 16.22% of the inclusions in SWL, with 84.83% of women. The pathologies with the highest rate of resignation have been Morton metatarsalgia (24%) and hallux rigidus (20.16%). The most frequent pathology, hallux valgus, records 15.96% of resignations that occur mostly between 6 and 9 months. In the CTS and IM, the resignation rate has been 17.42 and 8.92%, respectively, with higher resignation rates in the first 3 months.

CONCLUSIONS

The withdrawal of a scheduled intervention on the forefoot registers a high frequency in our environment, which can be related to factors such as the type of pathology, its natural history, response to orthopedic interventions, time in LEQ, and other non-specific ones on which we must investigate, to rationalize and establish duties in our SWL.