title: Family-centered care in children with epilepsy: Evaluating the Measure of Processes of Care (MPOC-20).
abstract: OBJECTIVE
  The objective was to test whether the five-domain structure of the Measure of Processes of Care (MPOC-20) was observed in a sample of children with epilepsy and, if not, to propose adaptations to improve its utility in this population.
  
  
  METHODS
  Data came from the Health-Related Quality of Life in Children with Epilepsy Study (HERQULES)-a multicenter prospective cohort study (n = 374) following children 4-12 years of age for 2 years after diagnosis. Confirmatory factor analysis (CFA) tested the applicability of the five domains/factors in a sample of children with epilepsy approximately 6 months following diagnosis (n = 311). Goodness-of-fit statistics were used to examine sources of ill model fit, and modification indices guided the model modification process where there was strong theoretical rationale for changes.
  
  
  RESULTS
  The five-factor model described by the originators of the MPOC-20 was found to be inadmissible in children with epilepsy, with four of the five factors demonstrating high correlations (r > 0.85). Upon merging the intercorrelated factors, a two-factor solution with a mediocre fit emerged (Root Mean Square Error of Approximation (RMSEA) = 0.080, Comparative Fit Index (CFI) = 0.902, Standardized Root Mean Square Residual (SRMR) = 0.060). Modification indices identified four items as the source of poor model fit. Removing these four items and reperforming the CFA resulted in an adequate model fit and a revised 16-item MPOC (RMSEA = 0.057, CFI = 0.958, SRMR = 0.036). The two factors are "Family/Care Provider Interaction" and "Providing Information."
  
  
  CONCLUSIONS
  Results suggest that the MPOC-16 better reflects family-centered care (FCC) in children with epilepsy than the original MPOC-20. The benefit of having fewer factors is that scoring is simpler and the interpretation of the results is easier. This was the first investigation of the factor structure of the MPOC-20 on a sample entirely composed of children with epilepsy. These results add to evidence that the factor structure (and how family-centered care is delivered and perceived) differs across treatment environments and treatment populations.
authors: Department of Epidemiology & Biostatistics, Western University, London, Ontario, Canada.|Children's Health Research Institute, Lawson Health Research Institute, London, Ontario, Canada.
authors: Kariym C
authors: KC
authors: Joachim
authors: Department of Epidemiology & Biostatistics, Western University, London, Ontario, Canada.|Children's Health Research Institute, Lawson Health Research Institute, London, Ontario, Canada.|Department of Paediatrics, Western University, London, Ontario, Canada.
authors: Piotr
authors: P
authors: Wilk
authors: Department of Epidemiology & Biostatistics, Western University, London, Ontario, Canada.|Department of Family Medicine, Western University, London, Ontario, Canada.
authors: Bridget L
authors: BL
authors: Ryan
authors: Department of Epidemiology & Biostatistics, Western University, London, Ontario, Canada. kathy.speechley@lhsc.on.ca.|Children's Health Research Institute, Lawson Health Research Institute, London, Ontario, Canada. kathy.speechley@lhsc.on.ca.|Department of Paediatrics, Western University, London, Ontario, Canada. kathy.speechley@lhsc.on.ca.
authors: Kathy N
authors: KN
authors: Speechley
mesh_terms: D000328:Adult; D002648:Child; D002662:Child Health Services; D002675:Child, Preschool; D015331:Cohort Studies; D003695:Delivery of Health Care; D004827:Epilepsy / Q000175:diagnosis* / Q000523:psychology*; D005163:Factor Analysis, Statistical; D005192:Family Health; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018802:Patient-Centered Care; D011594:Psychometrics; D011788:Quality of Life; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Children; Confirmatory factor analysis; Epilepsy; Family-centered care; Health-related quality of life; Measure of Processes of Care (MPOC-20); Measurement; Modification indices