Psychometric Properties of the Problem-Oriented Patient Experience-Primary Care (POPE-PC) Survey

Measuring the experiences of patients regarding delivery and receipt of person-oriented primary care is of increasing policy and research interest and is a core component of the Institute for Healthcare Improvement's Quadruple Aim.

To describe the Problem-Oriented Patient Experience-Primary Care (POPE-PC) survey, a novel instrument designed to measure patients' experiences of primary care, and to assess the instrument's psychometric properties.

Psychometric testing was performed using data from a Canadian urgent primary care center, derived from March 2019 to September 2019. Patients automatically received the 9-question survey by email after leaving the clinic. Exploratory factor analysis (EFA) on all questions and the entire dataset was performed using parallel analysis and scree plot for factor extraction. Internal consistency was assessed by calculating Cronbach α. A split-half cross-validation of the ensuing factor structure was conducted. A correlation analysis helped explore associations between the survey's questions.

Results from the initial EFA indicate that the POPE-PC has a conceptually sound 2-factor structure, with good internal consistency. A split-half validation yielded the same findings, reaffirming that the 2-factor model has good psychometric properties. The correlation analysis indicated that the concept of respect is strongly associated with clinical functions related to problem recognition.

Problem recognition, despite being the cornerstone of person-oriented primary care, remains largely overlooked in health services research. The POPE-PC's validity and problem orientation render it potentially useful in rigorously assessing patient experiences of problem-oriented primary care.

The survey's conceptual underpinning and psychometric properties, coupled with its simple and parsimonious design, enable application in primary care settings to provide person-oriented care.