Diseño y validación del cuestionario ACPAPS para valorar la atención centrada en la persona por el médico de familia

  1. Pascual López, José Antonio
Supervised by:
  1. Juan Francisco Menárguez Puche Director
  2. Jose Antonio Sánchez Hernández Director
  3. María Dolores Medina Abellán Director

Defence university: Universidad de Murcia

Fecha de defensa: 23 April 2024

Committee:
  1. Rosa Magallón Botaya Chair
  2. Domingo José Rubira López Secretary
  3. Remedios Martín Álvarez Committee member

Type: Thesis

Sustainable development goals

Abstract

The systematic review (SR) sought to obtain information on all existing tools in the literature capable of measuring some aspect or dimension of person-centred care (PCC). The Delphi study (DS) sought to find out the perspective of professionals on aspects and dimensions that should form an indispensable part of a tool for measuring PCC by the family doctor (GP). On the basis of the information obtained in the first two phases, the final objective of the research is the design, construction and validation of a self-completion test that can be filled out by the GP to check whether their clinical practice is patient-centred. Methodology A SR was conducted following the criteria of the PRISMA statement. We included validation studies of questionnaires or other tools to measure some aspect of PCA, SR on PCC measurement tools and studies carried out in primary care with validated tools to measure some aspect of PCC. All studies were analyzed and the quality of the tools was assessed using the COSMIN scale. In the DS, a group of experts was selected and sent a total of three questionnaires about the aspects they considered to be a priority for assessing PCC in an GP. The first questionnaire was open-ended, the second to assess the relevance of the items identified and the dimension to which they belonged, and the third to prioritize the items included on a Likert scale. With the results obtained in the SR and the DS, a bank of items was constructed and successive revisions were made to refine the number of items. Questions were reformulated and adapted for response according to a Likert scale and a review was carried out by a panel of experts. After this, a cognitive pre-test was carried out and the final tool was validated by sending the questionnaire to 62 of the 80 health centres in the Region. With the responses obtained, we measured reliability using Cronbach's Ⲁ, feasibility using the cognitive pretest, response rate (RR) and mean response time (MRT), and we assessed content validity, apparent or response process validity and construct validity by performing a factor analysis. Results In the SR, 1415 items were detected in which 39 tools measuring some aspect of PCC were identified. The DS identifies five main dimensions of PCC and 52 main aspects to consider when assessing PCC. Starting from a bank of 873 items from the SR and the DS and following the steps detailed above, a tool of 39 items is obtained for validation. The Cronbach's Ⲁ obtained is 0.915, the feasibility with a TR> 30%, TMR of 17 minutes and the performance of the cognitive pretest. Content validity, face validity and construct validity were tested by means of a factor analysis from which 5 factors were extracted that coincide with the dimensions identified as the main ones. The tool is finally composed of 37 items. Conclusions. We did not find any validated tool to assess PCC by GP and validated in our environment. The professionals identify five main dimensions and a series of items as necessary for the assessment of PCC. The ACPAPS tool, built on the basis of the SR and the DS, is capable of measuring PCC in primary care with adequate feasibility and validity and excellent reliability, which has multiple future applications both at the level of daily practice and at the training level.