Abstract
BackgroundIn England, prostate cancer patients report worse experience of care than patients with other cancers. However, no standard measure of patient experience of prostate cancer care is currently available. This paper describes an evaluation of the reliability, validity and acceptability of the PCQ-P, a newly developed instrument designed to measure patient experience of prostate cancer care.MethodsThe reliability, acceptability and validity of the PCQ-P were tested through a postal survey and interviews with patients. The PCQ-P was posted to 1087 prostate cancer patients varying in age, occupation, and overall health status, sampled from five hospitals in England. Nonresponders received one reminder. To assess criterion validity, 935 patients were also sent sections of the National Centre for Social Research Shortened Questionnaire; and to assess test-retest reliability, 296 patients who responded to the questionnaire were resent it a second time three weeks later. A subsample of 20 prostate cancer patients from one hospital took part in qualitative interviews to assess validity and acceptability of the PCQ-P. Acceptability to service providers was evaluated based on four hospitals' experiences of running a survey using the PCQ-P.ResultsQuestionnaires were returned by 865 patients (69.2%). Missing data was low across the sections, with the proportion of patients completing less than 50% of each section ranging from 4.5% to 6.9%. Across the sections of the questionnaire, internal consistency was moderate to high (Cronbach's alpha ranging from 0.63 to 0.80), and test-retest stability was acceptable (intraclass correlation coefficients ranging from 0.57 to 0.73). Findings on criterion validity were significant. Patient interviews indicated that the PCQ-P had high face validity and acceptability. Feedback from hospitals indicated that they found the questionnaire useful, and highlighted important considerations for its future use as part of quality improvement initiatives.ConclusionThe PCQ-P has been found to be acceptable to patients and service providers, and is ready for use for the measurement of patient experience in routine practice, service improvement programmes, and research.
Highlights
In England, prostate cancer patients report worse experience of care than patients with other cancers
Our aim was to develop a robust and acceptable measure suitable for use in routine practice and research. This paper describes such a measure of patient experience of prostate cancer care - the Prostate Care Questionnaire for Patients (PCQ-P) - and reports on the formal evaluation of the measure's reliability, validity and acceptability to patients and service providers
Development and characteristics of the PCQ-P The PCQ-P is a measure developed from preliminary research designed to determine the issues most important to prostate cancer patients, including a literature review of the experiences of patients of prostate cancer care, and interviews with patients and service providers [10,11,12]
Summary
In England, prostate cancer patients report worse experience of care than patients with other cancers. This paper describes an evaluation of the reliability, validity and acceptability of the PCQ-P, a newly developed instrument designed to measure patient experience of prostate cancer care. In this paper we report the reliability and validity of a questionnaire to measure the experience of prostate cancer care. In England, patients with prostate cancer report worse experience of care than patients with other cancers [1,2], and the provision of readily usable measures was one element of a wider initiative designed to improve services [3,4]. Measures of patients' experience - which comprise patients' reports of what happened in specific aspects of the delivery of care - are simpler to interpret and act upon than measures of satisfaction [7]. Surveys of experience are generally preferred by providers, and considered helpful in evaluating and improving services
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