Psychometric evaluation of an instrument to assess patient-reported 'psychosocial care by physicians': a structural equation modeling approach.
OBJECTIVE
The objective of our study was to develop a theory-based and empirically tested instrument for measuring patient-reported 'psychosocial care by physicians'. We propose a model integrating patients' perceptions with respect to: (i) devotion by physicians, (ii) support by physicians, (iii) information by physicians and (iv) shared decision-making (SDM).


METHODS
Data were gathered during 2001 within a cross-sectional, retrospective mail survey.


METHODS
A total of 4192 inpatients of six German hospitals.


METHODS
Specific scales of the Cologne Patient Questionnaire were used. A two-step structural equation model procedure was applied. In the first structural equation model, all items were modeled as indicators of the intended underlying latent construct, 'psychosocial care by physicians'. In the second structural equation model, criterion-related validity of the intended construct was tested with respect to patients' 'satisfaction', 'trust in physicians' and the 'image of the hospital'.


RESULTS
The results confirmed that the aspects of psychosocial care provided by physicians measured by the scale items are indeed indicators of the same construct. Furthermore, indicator reliabilities and selectivities revealed that the content of all 13 items was highly representative of the underlying construct. The second structural equation model showed that 'psychosocial care by physicians' is related to 'patients' satisfaction', 'trust in physicians' and 'hospital-image' in a significant and relevant manner.


CONCLUSIONS
On the basis of our instrument's reported psychometric characteristics and of the initial validity indicators, it may be regarded as an adequate measure for further use in outcome and intervention research, and as a quality indicator for the physician-patient relationship.
Ommen
Oliver
O
Center for Health Services Research Cologne, University Hospital of Cologne, Eupener Strasse 129, Cologne 50933, Germany. oliver.ommen@uk-koeln.de
Wirtz
Markus
M
Janssen
Christian
C
Neumann
Melanie
M
Driller
Elke
E
Ernstmann
Nicole
N
Loeffert
Sabine
S
Pfaff
Holger
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D017060:Patient Satisfaction; D010361:Patients / Q000523:psychology*; D010817:Physician-Patient Relations; D011594:Psychometrics; D011785:Quality Assurance, Health Care; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D055815:Young Adult