Patient Assessment of Chronic Illness Care (PACIC) in Type 2 Diabetes: A Longitudinal Study.
The Patient Assessment of Chronic Illness Care (PACIC) was designed to measure care congruent with several elements of the chronic care model (CCM), including self-management support and delivery system design. However, support for the a priori 5-subscale structure of the PACIC in previous research has been conflicting. Thus, we aim to investigate psychometric characteristics of the PACIC including the content and stability of its construct over time. A population-based prospective cohort study of patients with type 2 diabetes was conducted in Queensland, Australia, from 2008 (N = 3,761) to 2010 (N = 3,040). Participants completed annually the 20-item PACIC as well as measures of providers' adherence to guideline-recommended self-management support activities. We used exploratory factor analysis to determine its factor structure and examined internal consistency as well as agreement between the PACIC at baseline with repeated measurements at follow-up after 1 and 2 years. We also determined a criterion-related validity using multinomial logistic regression to explore PACIC's association with providers' self-management support. A one-factor structure was deemed optimal according to our findings. High internal consistency and moderate agreement within the scales over time were observed. Higher PACIC scores predicted better providers' self-management support. In conclusion, the PACIC is a reliable, valid, and reproducible instrument for assessment of diabetes care, and we recommend its promotion and use as a single scale rather than subscales as originally proposed.
School of Population Health, University of Queensland, Brisbane, Queensland, Australia e.aung@uq.edu.au.
Eindra
E
Aung
School of Population Health, University of Queensland, Brisbane, Queensland, Australia.
Remo
R
Ostini
School of Population Health, University of Queensland, Brisbane, Queensland, Australia.
Jo
J
Dower
School of Medicine, University of Queensland.
Maria
M
Donald
School of Population Health, University of Queensland, Brisbane, Queensland, Australia.
Joseph R
JR
Coll
School of Population Health, University of Queensland, Brisbane, Queensland, Australia.
Gail M
GM
Williams
School of Population Health, University of Queensland, Brisbane, Queensland, Australia.
Suhail A R
SA
Doi
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D002908:Chronic Disease; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology* / Q000628:therapy*; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D063868:Patient Outcome Assessment; D017060:Patient Satisfaction; D015397:Program Evaluation; D011446:Prospective Studies; D011594:Psychometrics; D011787:Quality of Health Care; D015203:Reproducibility of Results; D012648:Self Care; D011795:Surveys and Questionnaires / Q000592:standards*
PACIC; patient perspectives; psychometrics; quality assessment; self-management support