title: Extending the assessment of patient-centredness in health care: Development of the updated Valuing Patients as Individuals Scale using exploratory factor analysis.
abstract: OBJECTIVE
  To update and re-validate the Valuing Patients as Individuals Scale for use as a patient appraisal of received healthcare.
  
  
  BACKGROUND
  Healthcare in the United Kingdom and beyond is required to deliver high quality, person-centred care that is clinically effective and safe. However, patient experience is not uniform, and complaints often focus on the way patients have been treated. Legislation in United Kingdom requires health services to gather and use patients' evaluations of care to improve services.
  
  
  METHODS
  This study uses scoping literature reviews, cognitive testing of questionnaire items with patient and healthcare staff focus groups, and exploratory factor analysis.
  Data were collected from 790 participants across 34 wards in two acute hospitals in one National Health Service Health Board in Scotland from September 2011-February 2012. Ethics and Research and Development approval were obtained.
  
  
  RESULTS
  Fifty six unique items identified through literature review were added to 72 original Valuing Patients as Individuals Scale items. Face validity interviews removed ambiguous or low relevance items leaving 88 items for administration to patients. Two hundred and ninety questionnaires were returned, representing 37% response rate, 71 were incomplete. Thus 219 complete data were used for Exploratory Factor Analysis with varimax orthogonal rotation. This revealed a 31 item, three factor solution, Care and Respect; Understanding and Engagement; Patient Concerns, with good reliability, concurrent and discriminant validity in terms of gender. A shortened 10 item measure based on the top 3 or 4 loading items on each scale was comparable.
  
  
  CONCLUSIONS
  The Updated Valuing Patients as Individuals Scale is sufficiently developed to capture patient appraisals of received care.
  
  
  CONCLUSIONS
  The short scale version is now being routinized in real-time evaluation of patient experience contributing to this United Kingdom, National Health Service setting meeting its policy and legislative requirements.
authors.affiliation: School of Nursing and Health Sciences, University of Dundee, Dundee, UK.
authors.forename: Martyn C
authors.identifier: http://orcid.org/0000-0001-7759-3797
authors.initials: MC
authors.lastname: Jones
authors.affiliation: School of Health and Social Care, Edinburgh Napier University, Edinburgh, Scotland.
authors.forename: Brian
authors.initials: B
authors.lastname: Williams
authors.affiliation: School of Nursing and Health Sciences, University of Dundee, Dundee, UK.
authors.forename: Janice
authors.initials: J
authors.lastname: Rattray
authors.affiliation: School of Nursing and Health Sciences, University of Dundee, Dundee, UK.
authors.forename: Steve
authors.initials: S
authors.lastname: MacGillivray
authors.affiliation: Queen Margaret University, Edinburgh, UK.|Practice Development, NHS Tayside, Dundee, UK.
authors.forename: Debbie
authors.initials: D
authors.lastname: Baldie
authors.affiliation: Department of Nursing and Community Health, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.
authors.forename: Abdul-Razak
authors.initials: AR
authors.lastname: Abubakari
authors.affiliation: School of Nursing and Health Sciences, University of Dundee, Dundee, UK.
authors.forename: Joanne
authors.initials: J
authors.lastname: Coyle
authors.affiliation: Practice Development, NHS Tayside, Dundee, UK.
authors.forename: Susan
authors.initials: S
authors.lastname: Mackie
authors.affiliation: Practice Development, NHS Tayside, Dundee, UK.
authors.forename: Eileen
authors.initials: E
authors.lastname: McKenna
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005163:Factor Analysis, Statistical; D005260:Female; D017144:Focus Groups; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D018802:Patient-Centered Care / Q000592:standards*; D011369:Professional-Patient Relations; D019984:Quality Indicators, Health Care; D015203:Reproducibility of Results; D012606:Scotland; D012737:Sex Factors
keywords: delivery of health care; exploratory factor analysis; general; healthcare quality assessment; healthcare surveys; hospitals; patient acceptance of health care; patient-centred care; quality of health care