Development and psychometric evaluation of the medical visit accompaniment service needs scale for older outpatients (MVASNS)

Medical visit accompaniment (MVA) services can help older outpatients navigate complex outpatient care processes by providing continuous accompaniment and non-clinical assistance throughout the visit. Existing measures and studies have focused on willingness to use MVA services or preferences for specific service attributes, while validated tools for assessing older outpatients’ multidimensional MVA service needs remain limited. This study aimed to develop and psychometrically evaluate the Medical Visit Accompaniment Service Needs Scale for older outpatients (MVASNS). Based on a conceptual framework integrating ERG theory, findings from our previous qualitative study, and evidence from the literature, the initial item pool was refined through two-round Delphi expert consultation and pilot testing. From April to July 2026, 764 older outpatients were recruited from two tertiary hospitals and one community health service centre in Zhejiang Province, China. After quality screening, 739 valid questionnaires were randomly divided into exploratory (n = 369) and confirmatory (n = 370) samples. Psychometric evaluation included content validity, item analysis, structural validity, convergent and discriminant validity, internal consistency, split-half reliability, and test–retest reliability. Floor and ceiling effects were also examined. The preliminary 33-item version showed satisfactory content validity (S-CVI/Ave = 0.949). Two items were removed during exploratory factor analysis, yielding a 31-item scale with three domains: basic service needs (12 items), emotional support and learning needs (8 items), and service quality needs (11 items). The three factors explained 52.825% of the total variance, and exploratory graph analysis identified item groupings consistent with this three-factor solution. Confirmatory factor analysis supported the three-factor structure with acceptable model fit (robust CFI = 0.950, robust TLI = 0.946, robust RMSEA = 0.055, and SRMR = 0.037). Convergent and discriminant validity were satisfactory. The total-scale Cronbach’s α was 0.962, the Spearman–Brown coefficient was 0.968, and the test–retest ICC was 0.927 (95% CI 0.816–0.968). No substantial floor or ceiling effects were observed for the total scale or its domains. The MVASNS showed initial evidence of validity and reliability for assessing older outpatients’ MVA service needs. Not applicable.