Abstract
BackgroundEffective patient-centred health care requires internal participation, which is defined as interprofessional patient-centred teamwork. Many scales are designed for measuring teamwork from the perspective of one type of health care professional (e.g. physician or nurse), rather than for the use for all health care professionals as well as patients. Hence, this paper’s purpose is to develop a scale for measuring internal participation from all relevant perspectives and to check its psychometric properties.MethodsIn a multicentre cross-sectional study, a 6-item Internal Participation Scale (IPS) was developed and administered to 661 health care professionals (staff) and 1419 patients in 15 rehabilitation clinics to test item characteristics, acceptance, reliability (internal consistency) and construct validity. Additionally, we performed an exploratory factor analysis (EFA) to determine the factorial structure and explained variance. Confirmatory factor analysis (CFA) was used to verify the theoretically assumed one-dimensional factorial structure.ResultsA total of 275 health care professionals and 662 patients participated, and the complete data sets of 272 staff members and 536 patients were included in the final analysis. The discrimination index was above .4 for all items in both samples. Internal consistency was very good, with Cronbach’s alpha equalling .87 for the staff and .88 for the patient sample. EFA supported a one-dimensional structure of the instrument (explained variance: 61.1% (staff) and 62.3% (patients)). CFA verified the factorial structure, with the factor loadings exceeding .4 for five of six items in both samples. Global goodness-of-fit indices indicated a good model fit, with a Tucker-Lewis index (TLI) of .974 (staff) and .976 (patients) and a comparative fit index (CFI) of .988 (staff) and .989 (patients). The root mean square error of approximation (RMSEA) amounted to .068 for the patient sample and .069 for the staff sample. There is evidence of construct validity for both populations.ConclusionsThe analysis of the scale’s psychometric properties resulted in good values. The scale is a promising instrument to assess internal participation from the perspective of both patients and staff. Further research should investigate the scale’s psychometric properties in other interprofessional health care settings to examine its generalizability as well as its sensitivity to change.
Highlights
Effective patient-centred health care requires internal participation, which is defined as interprofessional patient-centred teamwork
Internal participation is a key factor to increase the effectiveness of health care services [10]; it can help to enhance patient-centredness, patient safety and successful treatment [11,12,13,14,15,16,17] and is associated with improved patient satisfaction [17,18,19] and employee satisfaction [11] as well as cost savings [11,20]
Each clinic determined a contact person responsible for the study process: all surveys were sent to this contact person, who distributed them to the patients at the end of their stay in the rehabilitation clinic and to health care professionals in the treatment team
Summary
Effective patient-centred health care requires internal participation, which is defined as interprofessional patient-centred teamwork. Based on the model of integrated patient-centredness [8,9], the core dimension of patient-centredness is participation – patient participation in the encounter between patient and health care professional (external participation) as well as participation within the interprofessional team of health care professionals (internal participation) [8,9]. Both participation forms are described through four Cs – communication, cooperation, coordination, and (working) climate (see Figure 1). Internal participation is a key factor to increase the effectiveness of health care services [10]; it can help to enhance patient-centredness, patient safety and successful treatment [11,12,13,14,15,16,17] and is associated with improved patient satisfaction [17,18,19] and employee satisfaction [11] as well as cost savings [11,20]
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