Abstract
BackgroundThe Patient Enablement Instrument (PEI), which has been used to evaluate core ingredients in primary care consultations, has been proposed as a means of moving beyond patient satisfaction evaluations. The aim of the present study was to examine the reliability and applicability of the PEI to the Swedish context.MethodsThe original PEI was translated to Swedish and included in a questionnaire that was given to consecutively scheduled patients in four primary care settings. Respondents completed identical questionnaires immediately after a consultation, as well as two days and two weeks later. The analysis focused on internal reliability, test-retest reliability and internal construct validity.ResultsMean PEI scores declined significantly between baseline (3.48, SD 3.21) and the first follow-up questionnaire (3.06, SD 3.37). All three questionnaires showed high internal consistency (Cronbach’s alpha >0.85). Test-retest showed moderate agreement for all questions when comparing baseline and the first follow-up (kappa 0.54-0.65) and greater consistency between the two follow-up questionnaires (kappa 0.65-0.75). A large proportion of respondents characterized at least one of the questions as irrelevant (39%).ConclusionsThe Swedish version of the PEI instrument has high internal consistency and moderate to good reliability. It can be used in research but is not recommended as a measure of quality of care. The instrument could benefit from further development and validity testing.Electronic supplementary materialThe online version of this article (doi:10.1186/s12875-015-0242-9) contains supplementary material, which is available to authorized users.
Highlights
The Patient Enablement Instrument (PEI), which has been used to evaluate core ingredients in primary care consultations, has been proposed as a means of moving beyond patient satisfaction evaluations
The response rate declined with each succeeding questionnaire (Q1 = 148, questionnaire 2 (Q2) = 86, questionnaire 3 (Q3) = 72), and only 68 patients (41%) responded to all three of them
A Wilcoxon signed rank test showed that PEI scores were significantly higher on questionnaire 1 (Q1) than Q2 (Z = −2.90. p = 0.01)
Summary
The Patient Enablement Instrument (PEI), which has been used to evaluate core ingredients in primary care consultations, has been proposed as a means of moving beyond patient satisfaction evaluations. The aim of the present study was to examine the reliability and applicability of the PEI to the Swedish context. Various aspects of patient-doctor consultations have been examined by several studies with the aim of defining good quality of care in general practice (GP). The focus has been on methods of evaluating perceived core ingredients of a consultation, such as patient-centeredness, empowerment, and holism. As that could have a large impact on primary health care providers it is of major importance that such instrument meet high quality levels and is proven robust and applicable
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