A 16-item short version of the Heart Continuity of Care Questionnaire was developed, demonstrating acceptable confirmatory factor analysis model fit (RMSEA=0.079, CFI=0.96, TLI=0.97).
A 16-item short version of the Heart Continuity of Care Questionnaire was developed, demonstrating acceptable psychometric properties to reduce respondent burden in post-PCI patients.
Effect estimate: RMSEA=0.079, CFI=0.96, TLI=0.97
Abstract Background Continuity of care is crucial for optimizing long-term cardiac management after percutaneous coronary intervention (PCI) and is associated with improved disease monitoring, patient-reported outcomes, and quality of life. Although the Heart Continuity of Care Questionnaire (HCCQ) is a comprehensive and reliable measure of informational, relational, and management continuity, its length (33 items) may increase respondent burden and limit feasibility and data quality in clinical practice and large-scale studies. Purpose To develop a short version of the HCCQ. Methods The development process had two phases. Phase 1 focused on content validity through a qualitative, systematic conceptual assessment of the questionnaire to inform item reduction. Phase 2 involved assessing the psychometric properties of the short version. The developer of the original HCCQ was consulted prior to the development process and a statistician was involved throughout. Phase 1 consisted of three expert consensus meetings involving clinicians and research experts in cardiac care, evaluating clinical relevance, comprehensiveness and conceptual coverage of items. Further, item reduction was guided by cross-loadings and standardized factor loadings of the original HCCQ, to support factorial clarity and overall 3-factor model fit. Patient representatives reviewed the proposed short version to assess if the included items provided coverage of the construct. Results Through thorough discussion and full expert consensus, items important to the construct of continuity of care were retained, while items considered ambiguous, conceptually overlapping or prone to inconsistent interpretation were removed. Item selection further prioritized items with higher factor loadings and items that were more often assessed as relevant in previous analyses. Informational continuity was reduced from 17 to 6 items, all demonstrating factor loadings 0.70 and covering essential items, including condition, medication, lifestyle, and physical activity. Relational continuity was reduced to 6 items, including communication between and involvement of healthcare providers, access to care and consistent information. Four items were excluded due to conceptual overlap with items showing higher factor loadings. Management continuity was reduced to four items, including review of treatment plan and medication management, and regular appointments. Two items with content captured by similar items with stronger factor loadings were excluded. The resulting short version comprised 16 items. Confirmatory factor analysis (CFA) converged well and yielded a chi-square of 375, RMSEA=0.079, CFI=0.96, and TLI=0.97. Conclusion The systematic qualitative conceptual assessment resulted in the selection of 16 items that are considered relevant and collectively provide a comprehensive representation of continuity of care. The CFA showed acceptable numbers, also compared to a previous CFA for the full HCCQ.
Pannekoeke et al. (Wed,) conducted a other in Post-percutaneous coronary intervention (PCI). Short version of the Heart Continuity of Care Questionnaire (HCCQ) vs. Original 33-item HCCQ was evaluated on Psychometric properties and model fit of the short version (RMSEA=0.079, CFI=0.96, TLI=0.97). A 16-item short version of the Heart Continuity of Care Questionnaire was developed, demonstrating acceptable confirmatory factor analysis model fit (RMSEA=0.079, CFI=0.96, TLI=0.97).