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[Evaluation of the patient centered clinical relationship: analysis of psychometric properties using the CICAA scale]
Enrique Gavilán Moral1, Roger Ruiz Moral, Luis Angel Perula de Torres
1Unidad Docente de Medicina Familiar y Comunitaria, Gerencia de Salud del Area de Plasencia, Cáceres, España. enrique.gavilan@ses.juntaextremadura.net
Objective:
To analyse the psychometric properties by a scale for evaluating patient centered clinical communication.
Design:
Validation and observational study of a measurement tool.
Setting:
Health centres and hospital outpatient clinics.
Participants:
Three researchers independently evaluated video recorded interviews of different sub-samples: health professionals (family medicine medical residents, family doctors, specialist care physicians, and primary care nurses), actual patients who consulted for chronic or acute health problems, and standardised patients.
Primary Measurements:
Dimensionality (exploratory factor analysis), internal consistency (alpha de Cronbach), intra- and inter-observer agreement (Kappa index, intraclass correlation coefficient [ICC], generalisability), sensitivity to change (Student t test) and convergent validity with the GATHA questionnaire (Pearson correlation coefficient).
Results:
Six factors have been identified that explain 66.0% of the variance. The overall internal consistency of the test was alpha=0.94. The overall intra-observer agreement, measured with the ICC, varied between 0.94 and 0.97, whilst the inter-observer was between 0.82-0.90. The number of completed questionnaires required for the evaluator to obtain adequate reproducibility (generalisability) varied between 6 and 12. Statistical significance was not obtained when testing the sensitivity to change. The CICAA scale and the GATHA questionnaire had a correlation of 0.67.
Conclusions:
The CICAA scale is a generic patient centered clinical communication evaluation tool that may be used in different clinical contexts and situations, since it has shown to be reliable, valid and efficient.
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