Development and Validity of the Questionnaire of Patients’ Experiences in Postacute Outpatient Physical Therapy Settings

Abstract

Background: Patient feedback surveys are increasingly seen as a key component of 2 healthcare quality monitoring and improvement. Objective: To describe the 3 development and initial psychometric evaluation of a fixed-length questionnaire of 4 Patients’ Experiences undergoing physical therapy treatment in a Post-Acute 5 Outpatients settings (PEPAP-Q). Design: An instrument development study with 6 validity and reliability testing. Methods: A total of 465 patients from three 7 rehabilitation centres for musculoskeletal conditions completed the questionnaire. A 8 cognitive pretest was applied to the draft version (n=94), and a revised version was 9 tested for test-retest reliability (n=90). Analyses to evaluate variance and non-response 10 rates to items, the factor structure of the questionnaire and the metric properties of 11 multi-item scales were conducted. Results: Exploratory factor analyses yielded 12 evidence for a seven-factor structure to the PEPAP-Q, with three factors that may be 13 conceptually viewed as professionals’ attitudes and behaviour (providing information 14 and education, sensitive manners to patients’ changes and emotional support) and four 15 factors conceptually reflecting organizational environment (attendance duration, 16 interruptions during care delivery, waiting times and patient safety). Item scale 17 correlations ranged from 0.70 to 0.93. The percentage of scaling success was 100% for 18 all the scales. Cronbach’s alpha coefficient ranged from 0.70 to 0.87. Intraclass 19 correlation coefficients ranged from 0.57 to 0.80 (median=0.68). Limitations: 20 Generalization to other patients is not known. Conclusion: The PEPAP-Q is a reliable 21 test-retest and the scales have internal consistency and convergent and discriminant 22 validity. All the scales are distinct and unidimensional.