Development of the client-centred care questionnaire

This paper reports the development and testing of the Client-Centred Care Questionnaire, aimed at evaluating the client-centredness of professional home nursing care from a client perspective.

Client-centred care has become an important theme in health care. To evaluate the client-centredness of care and services from a client's perspective, there is a need for measurement instruments.

The questionnaire was developed on the basis of a qualitative study into client perspectives on home nursing care. Items were formulated that closely followed the aspects clients mentioned as central to client-centred home care. A pilot study was conducted with a sample of 107 clients in three home care organizations in 2003 and 2004. These clients had chronic diseases and were expected to receive care for at least another 6 months. The questionnaire comprises 15 items.

Principal components analysis and internal consistency analysis show strong internal consistency of the items. All items had strong factor loadings on one dimension, and Cronbach's alpha was 0.94. Clients tended to be most critical about their say in the practical arrangements and organization of care: which person came, how often and when? Clients of the three organizations differed in their perceptions of client-centredness, which may indicate that the questionnaire is capable of differentiating between respondents.

The results of this pilot study are promising. The validity of the questionnaire needs further testing.