[Evaluation of the patient centered clinical relationship: analysis of psychometric properties using the CICAA scale].
OBJECTIVE
To analyse the psychometric properties by a scale for evaluating patient centered clinical communication.


METHODS
Validation and observational study of a measurement tool.


METHODS
Health centres and hospital outpatient clinics.


METHODS
Three researchers independently evaluated video recorded interviews of different sub-samples: health professionals (family medicine medical residents, family doctors, specialist care physicians, and primary care nurses), actual patients who consulted for chronic or acute health problems, and standardised patients.


METHODS
Dimensionality (exploratory factor analysis), internal consistency (alpha de Cronbach), intra- and inter-observer agreement (Kappa index, intraclass correlation coefficient [ICC], generalisability), sensitivity to change (Student t test) and convergent validity with the GATHA questionnaire (Pearson correlation coefficient).


RESULTS
Six factors have been identified that explain 66.0% of the variance. The overall internal consistency of the test was alpha=0.94. The overall intra-observer agreement, measured with the ICC, varied between 0.94 and 0.97, whilst the inter-observer was between 0.82-0.90. The number of completed questionnaires required for the evaluator to obtain adequate reproducibility (generalisability) varied between 6 and 12. Statistical significance was not obtained when testing the sensitivity to change. The CICAA scale and the GATHA questionnaire had a correlation of 0.67.


CONCLUSIONS
The CICAA scale is a generic patient centered clinical communication evaluation tool that may be used in different clinical contexts and situations, since it has shown to be reliable, valid and efficient.
Unidad Docente de Medicina Familiar y Comunitaria, Gerencia de Salud del Area de Plasencia, Cáceres, España. enrique.gavilan@ses.juntaextremadura.net
Enrique
E
Gavilán Moral
Roger
R
Ruiz Moral
Luis Angel
LA
Perula de Torres
Juan Manuel
JM
Parras Rejano
D006801:Humans; D018802:Patient-Centered Care; D010817:Physician-Patient Relations; D011594:Psychometrics; D011795:Surveys and Questionnaires