Abstract
PurposeResearchers investigating person-centredness in older people’s long-term community care are hindered by the lack of appropriate measures. Studies have tended to rely on proxy indicators or generic instruments, risking invalid results. This new research aimed to develop and psychometrically test a person-centredness scale for use in older people’s community services.MethodsQuestionnaire items were sourced from groups of older people and mapped to a conceptual framework of person-centredness. A postal questionnaire in 2015–2016 tested these items with older people supported by mental health and social care services in five areas of England. Dimensionality was assessed through exploratory factor analysis and a confirmatory bifactor model, with classical item analysis removing weak items. Test–retest analysis was undertaken through a repeated postal questionnaire 3 weeks after the first.ResultsThree factors were identified, representing (i) interpersonal and (ii) organisational aspects of person-centred care; and (iii) negatively phrased items. Removing weaker items resulted in an 18-item scale. The bifactor analysis concluded the summary scale was ‘essentially unidimensional’. The Person-centred community care inventory (PERCCI) had excellent reliability, with Intra-Class Correlation Coefficient of 0.886 [95% CI 0.818–0.929]. A priori hypotheses about associations with satisfaction metrics and support variables were broadly confirmed.ConclusionsThe PERCCI has promising measurement properties and can be recommended for use in research with older adults using community mental health and social care services. Future developments must identify how sensitive the instrument is in detecting changing service quality.
Highlights
The language of ‘person-centredness’ is ubiquitous and forms the central plank of most quality improvement strategies across health and care systems worldwide [1]
The method used is outlined here to assist in understanding the results of subsequent psychometric testing.) To this end, two groups of older people were recruited through voluntary sector providers of mental health services in the North West of England, one serving a predominantly white population and another for those of south Asian heritage
This paper presents a large-scale study of the development and preliminary psychometric testing of the new 18-item Person-centred community care inventory (PERCCI)
Summary
The language of ‘person-centredness’ is ubiquitous and forms the central plank of most quality improvement strategies across health and care systems worldwide [1]. The term’s precise meaning varies between service settings, it can generally be understood to encompass approaches to care provision that recognises, respects and responds to the uniqueness of each individual [2]. The term is commonly used as a critique of approaches to health care delivery which privilege biomedical understanding of disease [3, 4], on the grounds that these can leave important needs unaddressed [5]. The influence of person-centredness can scarcely be overstated. The World Health Organization recently proposed a “fundamental paradigm shift” in service design based on person-centred. A near-unanimous view is held that the quality of evidence underpinning person-centredness fails to match its high status in policy rhetoric [7,8,9]. Measurement problems have been identified as a leading contributor to inconclusive and low-quality evidence [10,11,12,13], and in a review of expert opinion has been identified as a priority theme for action [14]
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