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Construct validity comparisons of three methods for measuring patient compliance.

K M Cummings, J P Kirscht, M H Becker

    Health Services Research
    |April 1, 1984
    PubMed
    Summary

    Assessing patient compliance in hemodialysis patients revealed nurse ratings as the most valid method, though still imperfect. Further research is needed to develop better compliance assessment tools.

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    Area of Science:

    • Nephrology
    • Patient Adherence Research
    • Health Services Research

    Background:

    • Patient compliance is crucial for managing chronic conditions like end-stage renal disease (ESRD).
    • Accurate assessment of patient compliance is essential for effective treatment and patient outcomes.
    • Current methods for measuring patient compliance vary in their validity and reliability.

    Purpose of the Study:

    • To evaluate the construct validity of three common patient compliance assessment methods.
    • To compare the validity of physiological assessments, health professional ratings, and patient self-reports.
    • To identify the most reliable method for assessing compliance in ambulatory hemodialysis patients.

    Main Methods:

    • A multitrait-multimethod design was utilized.

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  • The study included patients undergoing ambulatory hemodialysis for ESRD.
  • Three methods were assessed: physiological measures, nurse ratings, and patient self-reports.

    • Main Results:

    • Nurse ratings demonstrated the highest validity among the three methods, with approximately 50% valid variance.
    • Physiological assessments showed substantial residual error, exceeding 70%.
    • Patient self-reports exhibited low validity (12%), with significant method-effects variance (18%) and residual error (68%).

    Conclusions:

    • Nurse ratings represent the most valid approach currently available for assessing patient compliance in this population, despite limitations.
    • Physiological assessments and patient self-reports are less valid and reliable for measuring patient compliance behaviors.
    • There is a critical need for developing and validating improved methods to accurately assess patient compliance in clinical practice.