Patient Satisfaction with Navigator Interpersonal Relationship (PSN-I): item-level psychometrics using IRT analysis

Area of Science:

• Health Services Research
• Psychometrics
• Oncology

Background:

• Patient navigation (PN) is a key strategy for reducing cancer health disparities.
• Patient satisfaction with navigators is crucial for PN program effectiveness.
• The Patient Satisfaction with Interpersonal Relationship with Navigators (PSN-I) scale measures this satisfaction.

Purpose of the Study:

• To establish the item-level psychometric properties of the PSN-I scale.
• To validate the PSN-I scale using item response theory (IRT) analysis.
• To confirm the reliability and validity of the PSN-I for assessing patient satisfaction with navigators.

Main Methods:

• Confirmatory factor analysis (CFA) was used to assess the unidimensionality of the 9-item PSN-I in 751 cancer patients.
• Unidimensional IRT models, including the graded response model (GRM) and Rasch model, were fitted to the data.
• Model fit was compared using likelihood ratio tests and information criteria, with item parameter estimates (IPEs) obtained.

Main Results:

• CFA confirmed a one-factor model fit for the PSN-I scale.
• The graded response model (GRM) demonstrated a significantly better fit to the data compared to the Rasch model.
• Item parameter estimates indicated substantial variation in the discriminating power of PSN-I items.

Conclusions:

• IRT analysis validates the latent structure of the PSN-I scale.
• The PSN-I is a reliable and valid measure for assessing patient satisfaction with patient navigators.
• Findings support the use of the PSN-I in evaluating PN programs and addressing cancer health inequities.