Development of a patient reported experience measure in chronic obstructive pulmonary disease (COPD)
Student thesis: Doctoral Thesis
The experience of patients living with chronic obstructive pulmonary disease (COPD) and their views on the quality of healthcare they receive is not currently captured in patient reported measures. Aim: To develop and validate a patient reported experience measure to assess experiences of living with COPD and perceived quality of healthcare provision. Method: Previous work with 83 COPD patients identified 38 items for inclusion ina patient reported experience measure. These, together with the COPD Assessment Test and Hospital Anxiety and Depression Scale were administered to patients with COPD. Items demonstrating significant gender or age bias(p<0.05), floor or ceiling effects (set at 40%), missing data >15%, or high item to item correlations (r>0.8) were removed. Rasch analysis was applied to the remaining items. Results: 174 patients (Mean age 71 years, SD 9; 91 female; Mean Forced Expiratory Volume1 59%, SD 21.9) were studied. 29 items were removed,providing a 9-item unidimensional scale (chi-square p=0.33) with a wide scaling range (logits from -0.1 to +0.2). These cover experiences of living with COPD (e.g.I feel that I am in control of my condition) and health care (e.g. I am concerned that my GP won't listen to my point of view). Internal consistency was good (PSI= 0.77)and correlations between the COPD PREM-9, COPD Assessment Test and Hospital Anxiety and Depression Scale were moderate (r=0.42 and r=0.30,respectively). Conclusions: The COPD PREM-9 demonstrated good internal reliability and showed a wide scaling range suggesting, regardless of severity, people with COPD can have good or bad experiences. There were low to moderate correlations with the COPD Assessment Test and Hospital Anxiety and Depression Scale, which suggests the PREM COPD-9 is measuring a different concept. The COPD PREM-9 may be a useful measure of quality of care that complements measures of health status and mood.
7.48 MB, PDF document