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Abstract
Introduction Patient-reported experience measures (PREMs) are useful tools to assess patient- centeredness (PC) from the patients’ perspective and thereby enable improvement of PC. We developed the Experienced Patient-Centeredness Questionnaire (EPAT) based on an integrative model of PC which includes 16 domains.1–3 The EPAT is disease-generic and includes an inpatient and an outpatient version. The aim of this study was to assess the psychometric properties of the EPAT and select items for a short version (EPAT-16) and a module version (EPAT-64).
Methods We tested the EPAT in a cross-sectional study including adult patients treated in inpatient or outpatient settings in Germany for one of the following conditions: cardiovascular diseases, cancer, musculoskeletal disorders, and mental disorders. For each of the 16 domains of PC, we selected four items based on item characteristics (e.g., item difficulty, item-total correlation, content). We tested structural validity using confirmatory factor analysis, calculated Cronbach’s alpha for internal consistency, and examined correlations with general health status and satisfaction for construct validity.
Results Overall 2,024 patients were included in the analyses. All items of the EPAT showed excellent acceptance and acceptable item-total correlations. A few items showed ceiling effects. Confirmatory factor analysis of the EPAT-64 showed best fit of a bi-factorial model. Construct validity was confirmed for most of the domains. Cronbach’s alpha was >0.7 for all but one domain.
Discussion The EPAT is the first PREM to comprehensively assess patient-centeredness. It is based on a thorough development and item selection process combining theory and data driven decisions. Psychometric testing in a large sample demonstrated good psychometric properties.
Conclusions The different versions of the EPAT allow a flexible adaptation to the users’ need. The EPAT can be used e.g., for quality measures or to evaluate interventions aimed at improving PC.
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