Harun KIRILMAZ, Ceyda ATAÇ, Mustafa ERDOĞAN, Ali ARSLANOĞLU

Hasta Merkezli Bakım Ölçeğinin Türkçe Geçerlilik ve Güvenilirliği

Amaç: Bu araştırmanın amacı, hasta perspektifinde hasta merkezli bakım algısını ölçmeyi hedefleyen geçerli ve güvenilir bir ölçeği Türkçeye uyarlamaktır. Gereç ve Yöntem: Hastaların hasta merkezli bakım algısını değerlendirmek için Cramm ve Nieboer tarafından geliştirilen Hasta Merkezli Bakım Ölçeği kullanılmıştır. Ölçeğin Türkçeye uyarlanmasında açıklayıcı ve doğrulayıcı faktör analizi ile güvenilirlik analizi yapılmıştır. Araştırmada kolayda örnekleme yöntemi tercih edilmiştir. Araştırmanın örneklemini çalışmaya katılmayı kabul eden 300 kişi oluşturmaktadır. Bulgular: Araştırmada örneklem yeterliliği için Kaiser-Meyer-Olkin değeri 0,866 ve Barlett’s testi anlamlıdır. Açıklayıcı faktör analizi sonucuna göre orijinal ölçekteki gibi sekiz boyuta ayrılmaktadır ve açıklanan toplam varyans %75,623’tür. Ölçeğin uyum iyiliği değerleri RMSEA= 0,046, NFI= 0,901, TLI= 0,954, CFI= 0,959, IFI= 0,959, GFI= 0,859 olup bu değerler kabul edilebilir değerlerdir. Ölçeğin Cronbach alfa değeri 0,961’dir. Ölçeğin boyutları arasında pozitif yönlü, orta ve yüksek düzeyde ilişki söz konusudur. Son olarak ölçeğin genel ortalaması 3,48 olarak tespit edilmiştir. Sonuç: Hasta Merkezli Bakım Ölçeğinin Türkçe uyarlaması, hasta perspektifinde kullanılabilecek geçerli ve güvenilir bir araçtır. Orijinal ölçeğin elde ettiği bulgular ile ölçeğin Türkçe uyarlamasında elde edilen bulgular örtüşmektedir. Bu doğrultuda ölçeğin, hastaların hasta merkezli bakım ile ilgili tutum ve düşüncelerini değerlendirmede kullanılabileceği düşünülmektedir.

Anahtar Kelimeler:

Hasta merkezlilik, hasta merkezli bakım, geçerlilik, güvenilirlik

Turkish validity and reliability of patient-centred care scale

Purpose: The aim of this study is to adapt a valid and reliable scale aiming to measure the perception of patient-centred care from the patient perspective into Turkish. Materials and Methods: The Patient-Centred Care Scale developed by Cramm and Nieboer was used to assess patients' perception of patient-centred care. In the adaptation of the scale to Turkish, explanatory, and confirmatory factor analysis and reliability analysis were performed. Convenience sampling method was preferred in the study. The sample of the study consisted of 300 people who agreed to participate in the study. Result: The Kaiser-Meyer-Olkin value for sampling adequacy was 0.866 and Barlett's test was significant. According to the results of the exploratory factor analysis, the scale is divided into eight dimensions as in the original scale and the total variance explained is 75.623%. The goodness of fit values of the scale are RMSEA= 0.046, NFI= 0.901, TLI= 0.954, CFI= 0.959, IFI= 0.959, GFI= 0.859 and these values are acceptable. Cronbach's alpha value of the scale is 0.961. There is a positive, medium, and high-level relationship between the dimensions of the scale. Finally, the overall mean of the scale was determined as 3.48. Conclusion: The Turkish adaptation of the Patient-Centred Care Scale is a valid and reliable tool that can be used from a patient perspective. The findings obtained in the original scale and the findings obtained in the Turkish adaptation of the scale overlap. In this direction, it is thought that the scale can be used to evaluate patients' attitudes and thoughts about patient-centred care.

Keywords:

Patient centredness, patient centred care, validity, reliability,

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Arslanoğlu, A. ve Kırılmaz, H. (2019). Hasta merkezli bakım yetkinliği (HMBY) ölçeğinin Türkçeye uyarlanması. Sağlık Akademisyenleri Dergisi, 6(2), 158-166.
Bann, C. M., Sirois, F. M. & Walsh, E. G. (2010). Provider support in complementary and alternative medicine: exploring the role of patient empowerment. The Journal of Alternative and Complementary Medicine, 16(7), 745-752.
Bayram, N. (2016). Yapısal eşitlik modellemesine giriş AMOS uygulamaları. Bursa: Ezgi Kitabevi.
Benjamins, J., Haveman-Nies, A., Gunnink, M., Goudkuil, A., & De Vet, E. (2021). How the use of a patient-accessible health record contributes to patient-centered care: scoping review. Journal of Medical Internet Research, 23(1), e17655.
Boissy, A. (2020). Getting to patient-centered care in a post–Covid-19 digital world: a proposal for novel surveys, methodology, and patient experience maturity assessment. NEJM Catalyst Innovations in Care Delivery, 1(4).
Büyüköztürk, Ş. (2014). Sosyal bilimler için veri analizi el kitabı. Ankara: Pegem A Yayıncılık.
Byrne, B.M. (2016). Structural equation modeling with AMOS: Basic concepts, applications, and programming. Routledge.
Christalle, E., Zeh, S., Hahlweg, P., Kriston, L., Härter, M., Zill, J., & Scholl, I. (2022). Development and content validity of the experienced patient‐centeredness questionnaire (EPAT)-A best practice example for generating patient‐reported measures from qualitative data. Health Expectations, 25(4), 1529-1538.
Comrey, A.L., & Lee, H.B. (2013). A first course in factor analysis (2nd Edition). New York (USA): Psychology Press.
Costello, A.B. and Osborne, J.W. (2005). Best practices in exploratory factor analysis: Four recommendations for getting the most from your analysis. Practical Assessment, Research & Evaluation, 10, 1-9.
Cramm, J.M., & Nieboer, A.P. (2018). Validation of an instrument for the assessment of patient-centred care among patients with multimorbidity in the primary care setting: the 36-item patient-centred primary care instrument. BMC Family Practice, 19, 1-10.
Cramm, J. M., & Nieboer, A. P. (2017). Validation of an instrument to assess the delivery of patient-centred care to people with intellectual disabilities as perceived by professionals. BMC Health Services Research, 17(1), 1-11.
De Witte, L., Schoot, T., & Proot, I. (2006). Development of the client‐centred care questionnaire. Journal of Advanced Nursing, 56(1), 62-68.
Demir, B. (2020). Sağlığın kavramsallaştırılması ve insan odaklı sağlık hizmetlerinde kalite ve akreditasyon perspektifi. İnsan ve İnsan Dergisi, 7(24), 62-83. https://doi.org/10.29224/insanveinsan.675151
Ehrenberg, A., Gustavsson, P., Wallin, L., Boström, A. M., & Rudman, A. (2016). New graduate nurses’ developmental trajectories for capability beliefs concerning core competencies for healthcare professionals: A national cohort study on patient‐centered care, teamwork, and evidence‐based practice. Worldviews on Evidence‐Based Nursing, 13(6), 454-462.
Erdoğan, M., ve Kırılmaz, H. (2020). Hasta merkezlilik ve hasta merkezli bakım. İnsan ve İnsan, 7(24), 97-126. https://doi.org/10.29224/insanveinsan.668806
Ferreira, R., & Amendoeira, J. (2020). Adaptação e validação do instrumento “Patient Centered-Care” para a cultura portuguesa. Revista da UI_IPSantarém-Unidade de Investigação do Instituto Politécnico de Santarém, 8(1), 238-245.
Fornell, C., & Larcker, D.F. (1981). Evaluating structural equation models with unobservable variables and measurement error. Journal of Marketing Research, 18(1), 39-50.
Gartner, J.B., Abasse, K. S., Bergeron, F., Landa, P., Lemaire, C., & Côté, A. (2022). Definition and conceptualization of the patient-centered care pathway, a proposed integrative framework for consensus: a Concept analysis and systematic review. BMC Health Services Research, 22(1), 1-24. https://doi.org/10.1186/s12913-022-07960-0
Glasgow RE, Wagner EH, Schaefer J, Mahoney LD, Reid RJ, Greene SM. (2005). Development and validation of the Patient Assessment of Chronic Illness Care (PACIC). Med Care, 43(5):436-44. doi: 10.1097/01.mlr.0000160375.47920.8c. PMID: 15838407.
Grover, S., Fitzpatrick, A., Azim, F.T., Ariza-Vega, P., Bellwood, P., Burns, J., & Ashe, M. C. (2022). Defining and implementing patient-centered care: An umbrella review. Patient Education and Counseling, 105(7), 1679-1688. https://doi.org/10.1016/j.pec.2021.11.004
Gusmano, M.K., Maschke, K.J., & Solomon, M.Z. (2019). Patient-centered care, yes; patients as consumers, no. Health Affairs, 38(3), 368-373. https://doi.org/10.1377/hlthaff.2018.05019
Hair, J., Black, W., Babin, B., & Anderson, R. (2010). Multivariate data analysis: A global perspective, Upper Saddle River, NJ: Pearson Prentice Hall.
Håkansson Eklund J, Holmström IK, Kumlin T, Kaminsky E, Skoglund K, Höglander J, Sundler AJ, Condén E, Summer Meranius M. (2019). "Same same or different?" A review of reviews of person-centered and patient-centered care. Patient Educ Couns. 2019 Jan;102(1):3-11. Doi: 10.1016/j.pec.2018.08.029. Epub 2018 Aug 26. PMID: 30201221.
Hambleton, R.K., & Patsula, L. (1999). Increasing the validity of adapted tests: Myths to be avoided and guidelines for improving test adaptation practices. Journal of Applied Testing Technology, 1(1), 1-13.
Hannum Rose, J., Bowman, K.F., O'Toole, E.E., Abbott, K., Love, T.E., Thomas, C., & Dawson, N.V. (2007). Caregiver objective burden and assessments of patient-centered, family-focused care for frail elderly veterans. The Gerontologist, 47(1), 21-33. https://doi.org/10.1093/geront/47.1.21
Hansen, L.S., Præstegaard, J., & Lehn-Christiansen, S. (2022). Patient-centeredness in physiotherapy–a literature mapping review. Physiotherapy Theory and Practice, 38(12), 1843-1856.
Hays, R.D., Shaul, J.A., Williams, V.S., Lubalin, J. S., Harris-Kojetin, L.D., Sweeny, S.F., & Cleary, P.D. (1999). Psychometric properties of the CAHPS™ 1.0 survey measures. Medical Care, 37(3), MS22-MS31.
Hernandez, S.E., Conrad, D. A., Marcus-Smith, M. S., Reed, P., & Watts, C. (2013). Patient centered innovation in health care organizations. Health Care Management Review, 38(2), 166 175.
Hogarty, K., Hines, C., Kromrey, J., Ferron, J., & Mumford, K. (2005). Communality and overdetermination the quality of factor solutions in exploratory factor analysis: The influence of sample size. Educational and Psychological Measurement, 65, 202-226.
Hu, L.T., & Bentler, P.M. (1995). Evaluating model fit. In R. H. Hoyle (Ed.), Structural equation modelling: Concepts, issues, and applications. London: Sage.
Hwang, J. I. (2015). Development and testing of a patient-centred care competency scale for hospital nurses. International Journal of Nursing Practice, 21(1), 43-51.
Kanat, M., Schaefer, J., Kivelitz, L., Dirmaier, J., Voigt-Radloff, S., Heimbach, B., & Glattacker, M. (2021). Patient-centeredness in the multimorbid elderly: a focus group study. BMC Geriatrics, 21(1), 1-12. https://doi.org/10.1186/s12877-021-02448-8
Karagöz Y. (2017). SPSS ve AMOS uygulamalı bilimsel araştırma yöntemleri ve yayın etiği. Ankara: Nobel Akademik Yayıncılık.
Karagöz, Y., ve Bardakçı, S. (2020). Bilimsel araştırmalarda kullanılan ölçme araçları ve ölçek geliştirme. Ankara: Nobel Akademik Yayıncılık.
Kırılmaz, H. ve Durmuş, A. (2023). İnsan odaklı sağlık hizmeti perspektifinde sağlıkta dönüşüm programının değerlendirilmesi, sosyal beşerî ve idari bilimler alanında uluslararası araştırmalar. İstanbul: Eğitim Yayınevi. Kline, R.B. (2011). Principles and practice of structural equation modeling. New York: Guilford Press.
Kuipers, S.J., Nieboer, A.P., & Cramm, J.M. (2020). Views of patients with multi-morbidity on what is important for patient-centered care in the primary care setting. BMC Family Practice, 21, 1-12. https://doi.org/10.1186/s12875-020-01144-7
Laird-Fick, H.S., Solomon, D., Jodoin, C., Dwamena, F.C., Alexander, K., Rawsthorne, L., & Smith, R.C. (2011). Training residents and nurses to work as a patient-centered care team on a medical ward. Patient Education and Counseling, 84(1), 90-97. https://doi.org/10.1016/j.pec.2010.05.018
Lee, Y. M., Song, J. E., Park, C., & Son, Y. J. (2019). Psychometric evaluation of the Korean version of patient-centered care scale for hospital nurses. Evaluation & The Health Professions, 42(3), 344-365.
Manzer, J.L., & Bell, A.V. (2022). The limitations of patient-centered care: The case of early long-acting reversible contraception (LARC) removal. Social Science & Medicine, 292, 114632. https://doi.org/10.1016/j.socscimed.2021.114632
Michael, K., Dror, M. G., & Karnieli-Miller, O. (2019). Students’ patient-centered-care attitudes: the contribution of self-efficacy, communication, and empathy. Patient Education and Counseling, 102(11), 2031-2037. https://doi.org/10.1016/j.pec.2019.06.004.
Nkrumah, J., & Abekah-Nkrumah, G. (2019). Facilitators and barriers of patient-centered care at the organizational-level: A study of three district hospitals in the central region of Ghana. BMC Health Services Research, 19(1), 1-11. https://doi.org/10.1186/s12913-019-4748-z
Perera, S., & Dabney, B. W. (2020). Case management service quality and patient-centered care. Journal of Health Organization and Management, 34(5), 551-568. https://doi.org/10.1108/JHOM-12-2019-0347
Ramos, M.M., Sebastian, R.A., Stumbo, S.P., McGrath, J., & Fairbrother, G. (2017). Measuring unmet needs for anticipatory guidance among adolescents at school-based health centers. Journal of Adolescent Health, 60(6), 720-726.
Ree, E., Wiig, S., Manser, T., & Storm, M. (2019). How is patient involvement measured in patient centeredness scales for health professionals? A systematic review of their measurement properties and content. BMC Health Services Research, 19, 1-13. https://doi.org/10.1186/s12913-018-3798-y
Rose, G.L., Bonnell, L.N., O'Rourke‐Lavoie, J.B., van Eeghen, C., Reynolds, P., Pomeroy, D., & Littenberg, B. (2022). Development and validation of the patient centeredness index for primary care. Journal of Clinical Nursing, 31(23-24), 3485-3497. https://doi.org/10.1111/jocn.16177
Ryan, B.L., Brown, J.B., Tremblay, P.F., & Stewart, M. (2019). Measuring patients’ perceptions of health care encounters: examining the factor structure of the revised Patient Perception of Patient-Centeredness (PPPC-R) questionnaire. Journal of Patient-Centered Research and Reviews, 6(3), 192-202.
Saygılı, M., Kar, A. ve Uğurluoğlu, Ö. (2020). Hasta merkezli bakım yetkinlik ölçeği: Türkçe geçerlilik ve güvenilirlik çalışması. Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi, 11(4), 416-426.
Scholl, I., Zill, J.M., Härter, M., & Dirmaier, J. (2014). An integrative model of patient-centeredness–a systematic review and concept analysis. Plos One, 9(9), e107828. https://doi.org/10.1371/journal.pone.0107828
Sidani, S., Collins, L., Harbman, P., MacMillan, K., Reeves, S., Hurlock‐Chorostecki, C., ... & van Soeren, M. (2014). Development of a measure to assess healthcare providers’ implementation of patient‐centered care. Worldviews on Evidence‐Based Nursing, 11(4), 248-257.
Tabachnick, B.G., & Fidell, L.S. (2015). Using Multivariate Statistics. (Çev. Baloğlu, M.). (6.baskı). Pearson Yayıncılık.
Terrien, N., Anthoine, E., & Moret, L. (2012). Développement et validation d’une échelle d’auto-évaluation des pratiques de bientraitance des patients ou des résidents par les professionnels de santé. Gériatrie et Psychologie Neuropsychiatrie du Vieillissement, 10(4), 403-411.
Waweru, E., Smekens, T., Orne-Gliemann, J., Ssengooba, F., Broerse, J., & Criel, B. (2020). Patient perspectives on interpersonal aspects of healthcare and patient-centeredness at primary health facilities: A mixed methods study in rural Eastern Uganda. Plos One, 15(7), e0236524. https://doi.org/10.1371/journal.pone.0236524
Wilkerson, L., Fung, C. C., May, W., & Elliott, D. (2010). Assessing patient-centered care: One approach to health disparities education. Journal of General İnternal Medicine, 25, 86-90. https://doi.org/10.1007/s11606-010-1273-5
World Health Organization. (2007). People-centred health care: A policy framework. World Health Organization Press, Geneva, Switzerland.
World Health Organization. (2015). WHO global strategy on integrated people-centred health services 2016-2026. https://www.who.int/servicedeliverysafety/areas/people-centred-care/en.