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Related Experiment Videos

Barriers to care: operationalizing the variable.

K A Melnyk1

  • 1School of Nursing, University of Rochester Medical Center, NY.

Nursing Research
|March 1, 1990
PubMed
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This study developed a reliable scale to measure consumer perceptions of healthcare barriers, identifying five key factors: relationship, cost, site, inconvenience, and fear. The provider-consumer relationship emerged as the most central barrier to preventive care access.

Area of Science:

  • Health Services Research
  • Patient Access to Care
  • Healthcare Consumer Behavior

Background:

  • Understanding consumer-perceived barriers is crucial for improving healthcare access.
  • Existing measures may not fully capture the multifaceted nature of these obstacles.
  • Secondary preventive care utilization is often hindered by various perceived costs and obstacles.

Purpose of the Study:

  • To develop and validate a psychometrically sound measure of perceived barriers to secondary preventive care.
  • To identify the key dimensions of consumer-perceived barriers in a healthcare context.
  • To propose a structural model of these barriers based on empirical data.

Main Methods:

  • A three-stage Delphi process with a 12-member panel to identify initial barrier indicators.

Related Experiment Videos

  • Survey administration to 800 employees of a not-for-profit organization (70% response rate).
  • Exploratory and confirmatory factor analyses to establish construct validity and refine the measurement scale.

    • Main Results:

    • A 54-item scale was developed from an initial pool of 81 items.
    • Five distinct factors emerged: Provider-Consumer Relationship, Cost, Site-Related, Inconvenience, and Fear.
    • Confirmatory factor analysis refined the scale, confirming its utility for measuring perceived barriers to secondary preventive care.

    Conclusions:

    • The developed scale effectively operationalizes perceived barriers to secondary preventive care.
    • The provider-consumer relationship factor was identified as central in the proposed model of healthcare barriers.
    • Findings provide a foundation for interventions aimed at reducing perceived obstacles to preventive services.