questionnaire validation: migrant perspective of hospital care marc a. bruijnzeels, phd gea c. van...
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Questionnaire validation:migrant perspective of hospital care
Marc A. Bruijnzeels, PhD
Gea C. van der Woerdt
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Outline
Background
Aim of the study
Methods
Results
Conclusion
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Background
Hospital Comparison System
36% ethnic minorities in Rotterdam
area, main groups:
Moroccans
Turks
Cape Verdians (West Africa)
Surinamese (South America)
Dutch Antilleans (Caribbean)
Adapt and extend the questionnaires
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Aim of the study
To investigate whether the developed
questionnaires are valid and reliable to measure
the quality of hospital care from
the migrants’ perspective
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Migrant Inpatient Outpatient Questionnaires
Based on:
Hospital Comparison System
questionnaires
Inpatient
Outpatient
15 focus group interviews with
migrant:
Inpatients
Outpatients
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Method of research
Pilot study with nine Rotterdam hospitals
Translation questionnaires
Selection on surname
Face-to-face interviews at home by bilingual interviewers
Reliability
Item acceptability, non-missing 10%
Questions to evaluate language use etc.
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Validity
Content validity
Answers on open questions
Construct validity
loading 0.60
alpha coefficient .70
Criterion validity
correlation with overall satisfaction
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Response
0 10 20 30 40 50 60
Surinamese
Antilleans
Cape Verdians
Moroccans
Turks
percentage
398 respondents contacted, response 39%: 157 interviews, 155 useful
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Reliability
Proportion missing data < 10%
4% thought language use was difficult
8% answer categories difficult
(yes, actually yes, actually no, no)
77% found it important or very important interviewer
from own culture
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Validity
Content:
answers on open questions suggested
no missing items
Constructs of outpatient questionnaire:
5 general dimension
1 new dimension
2 ethnic specific dimensions
(with at least half of the items added)
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General dimensions
number of
items
HCS MOQ
1. Information received about disease/ treatment 6 5
“Patient knew why treatment or medical examination was necessary”
2. Knowledge of doctors about disease/treatment 2 2
3. General opinion waiting room 5 3
4. Attitude of assistant X-ray ward 3 3
5. Attitude of assistant Blood test 3 3
Attitude of doctors 8 -
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New and ethnic specific dimensions Outpatient Q
1 new dimension with 2 general items:
Patients' autonomy
“doctor let me decide too”
“doctor asked for permission”
2 ethnic specific dimensions:
Attitude of doctors (take seriously and specific)
Attitude of doctors (time and attention)
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Attitude of doctors (take seriously and specific)
Doctor has an open attitude towards my culture
Doctor took my health complains seriously
Doctor tried to understand me
Doctor told bad news tactically
Doctor gave me a feeling to have prejudices
Doctor discriminated
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Relation with overall satisfaction
Outpatients questionnaire
Attitude of doctors (take seriously and specific) F 34.763**
Attitude of doctors (time and attention) F 4.857*
Inpatient questionnaire
Welcome on emergency admission F 16.640**
Attitude (in general) of nurses F 11.406**
Attitude (specific) of nurses F 9.308**
Knowledge of nurses about disease/treatment F 8.500**
Information from doctors and nurses on discharge F 8.341**
Information from doctors F 7.815****p 0.01; *p 0.05; Cursive: specific dimensions
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Conclusions
Dimensions
Migrant Inpatient and Outpatient Questionnaires valid regarding:
content
construct
criterion
internal reliability
Measuring quality of outpatient and inpatient hospital care
from the perspective of ethnic minorities, valid and reliable,
add ethnic specific items in questionnaire
www.migranthealth.net