TY - JOUR
T1 - Validation of the Rainbow Model of Integrated Care Measurement Tools (RMIC-MTs) in renal care for patient and care providers
AU - Valentijn, Pim P
AU - Pereira, Fernando
AU - Sterner, Christina W
AU - Vrijhoef, Hubertus J M
AU - Ruwaard, Dirk
AU - Hegbrant, Jörgen
AU - Strippoli, Giovanni F M
PY - 2019/9/19
Y1 - 2019/9/19
N2 - INTRODUCTION: Integrated service delivery is considered to be an essential condition for improving the management and health outcomes of people with chronic kidney disease (CKD). However, research on the assessment of integrated care by patients and care providers is hindered by the absence of brief, reliable, and valid measurement tools.OBJECTIVE: The aim of this study was to develop survey instruments for healthcare professionals and patients based on the Rainbow Model of Integrated Care (RMIC), and to evaluate their psychometric properties.DESIGN: The development process was based on the US Food and Drug Administration guidelines. This included item generation from systematic reviews of existing tools and expert opinion on clarity and content validity, involving renal care providers and chronic kidney patients. A cross-sectional, multi-centre design was used to test for internal consistency and construct validity.SETTING: Outpatient clinics in a large renal network.PARTICIPANTS: A sample of 30.788 CKD patients, and 8.914 renal care providers.METHODS AND ANALYSIS: Both survey instruments were developed using previous qualitative work and published literature. A multidisciplinary expert panel assessed the face and content validity of both instruments and following a pilot study, the psychometric properties of both instruments were explored. Exploratory factor analysis with principal axis factoring and with promax rotation was used to assess the underlying dimensions of both instruments; Cronbach's alpha was used to determine the internal constancy reliability.RESULTS: 17.512 patients (response rate: 56.9%) and 8.849 care providers (response rate: 69.5%) responded to the questionnaires. Factor analysis of the patient questionnaire yielded three internally consistent (Cronbach's alpha > 0.7) factors: person-centeredness, clinical coordination, and professional coordination. Factor analysis of the provider questionnaire produced eight internally consistent (Cronbach's alpha > 0.7) factors: person-centeredness, community centeredness, clinical coordination, professional coordination, organisational coordination, system coordination, technical and cultural competence. As hypothesised, care coordination patient and providers scores significantly correlated with questions about quality of care, treatment involvement, reported health, clinics' organisational readiness, and external care coordination capacity.CONCLUSION: This study provides evidence for the reliability and validity of the RMIC patient and provider questionnaires as generic tools to assess the experience with or perception of integrated renal care delivery. The instruments are recommended in future applications testing test-retest reliability, convergent and predictive validity, and responsiveness.
AB - INTRODUCTION: Integrated service delivery is considered to be an essential condition for improving the management and health outcomes of people with chronic kidney disease (CKD). However, research on the assessment of integrated care by patients and care providers is hindered by the absence of brief, reliable, and valid measurement tools.OBJECTIVE: The aim of this study was to develop survey instruments for healthcare professionals and patients based on the Rainbow Model of Integrated Care (RMIC), and to evaluate their psychometric properties.DESIGN: The development process was based on the US Food and Drug Administration guidelines. This included item generation from systematic reviews of existing tools and expert opinion on clarity and content validity, involving renal care providers and chronic kidney patients. A cross-sectional, multi-centre design was used to test for internal consistency and construct validity.SETTING: Outpatient clinics in a large renal network.PARTICIPANTS: A sample of 30.788 CKD patients, and 8.914 renal care providers.METHODS AND ANALYSIS: Both survey instruments were developed using previous qualitative work and published literature. A multidisciplinary expert panel assessed the face and content validity of both instruments and following a pilot study, the psychometric properties of both instruments were explored. Exploratory factor analysis with principal axis factoring and with promax rotation was used to assess the underlying dimensions of both instruments; Cronbach's alpha was used to determine the internal constancy reliability.RESULTS: 17.512 patients (response rate: 56.9%) and 8.849 care providers (response rate: 69.5%) responded to the questionnaires. Factor analysis of the patient questionnaire yielded three internally consistent (Cronbach's alpha > 0.7) factors: person-centeredness, clinical coordination, and professional coordination. Factor analysis of the provider questionnaire produced eight internally consistent (Cronbach's alpha > 0.7) factors: person-centeredness, community centeredness, clinical coordination, professional coordination, organisational coordination, system coordination, technical and cultural competence. As hypothesised, care coordination patient and providers scores significantly correlated with questions about quality of care, treatment involvement, reported health, clinics' organisational readiness, and external care coordination capacity.CONCLUSION: This study provides evidence for the reliability and validity of the RMIC patient and provider questionnaires as generic tools to assess the experience with or perception of integrated renal care delivery. The instruments are recommended in future applications testing test-retest reliability, convergent and predictive validity, and responsiveness.
KW - adolescent
KW - adult
KW - aged
KW - 80 and over
KW - ambulatory care facilities/statistics & numerical data
KW - child
KW - preschool
KW - cross-sectional studies
KW - delivery of health care, integrated/methods
KW - female
KW - health personnel/statistics & numerical data
KW - humans
KW - kidney/physiopathology
KW - male
KW - middle aged
KW - pilot projects
KW - psychometrics/statistics & numerical data
KW - renal insufficiency, chronic/physiopathology
KW - reproducibility of results
KW - surveys and questionnaires/statistics & numerical data
KW - young adult
KW - adolescenten
KW - volwassene
KW - oud
KW - 80 en ouder
KW - ambulante zorgfaciliteiten/statistieken en numerieke gegevens
KW - kind
KW - peuterschool
KW - cross-sectionele studies
KW - levering van gezondheidszorg, geïntegreerd/methoden
KW - vrouwelijk
KW - gezondheidspersoneel/statistieken en numerieke gegevens
KW - mensen
KW - nier/fysiopathologie
KW - mannelijk
KW - middelbare leeftijd
KW - pilot projecten
KW - psychometrie/statistieken & numerieke data
KW - nierinsufficiëntie, chronische/fysiopathologie
KW - reproduceerbaarheid van resultaten
KW - vragenlijsten en enquêtes/statistieken & numerieke data
KW - jong volwassene
U2 - 10.1371/journal.pone.0222593
DO - 10.1371/journal.pone.0222593
M3 - Article
C2 - 31536548
SN - 1932-6203
VL - 14
JO - PLoS ONE
JF - PLoS ONE
IS - 9
M1 - e0222593
ER -