Questionnaire validation:migrant perspective of hospital care

Marc A. Bruijnzeels, PhD

Gea C. van der Woerdt

Outline

Background

Aim of the study

Methods

Results

Conclusion

Background

Hospital Comparison System

36% ethnic minorities in Rotterdam

area, main groups:

Moroccans

Turks

Cape Verdians (West Africa)

Surinamese (South America)

Dutch Antilleans (Caribbean)

Adapt and extend the questionnaires

Aim of the study

To investigate whether the developed

questionnaires are valid and reliable to measure

the quality of hospital care from

the migrants’ perspective

Migrant Inpatient Outpatient Questionnaires

Based on:

Hospital Comparison System

questionnaires

Inpatient

Outpatient

15 focus group interviews with

migrant:

Inpatients

Outpatients

Method of research

Pilot study with nine Rotterdam hospitals

Translation questionnaires

Selection on surname

Face-to-face interviews at home by bilingual interviewers

Reliability

Item acceptability, non-missing 10%

Questions to evaluate language use etc.

Validity

Content validity

Answers on open questions

Construct validity

loading 0.60

alpha coefficient .70

Criterion validity

correlation with overall satisfaction

Response

0 10 20 30 40 50 60

Surinamese

Antilleans

Cape Verdians

Moroccans

Turks

percentage

398 respondents contacted, response 39%: 157 interviews, 155 useful

Reliability

Proportion missing data < 10%

4% thought language use was difficult

8% answer categories difficult

(yes, actually yes, actually no, no)

77% found it important or very important interviewer

from own culture

Validity

Content:

answers on open questions suggested

no missing items

Constructs of outpatient questionnaire:

5 general dimension

1 new dimension

2 ethnic specific dimensions

(with at least half of the items added)

General dimensions

number of

items

HCS MOQ

1. Information received about disease/ treatment 6 5

“Patient knew why treatment or medical examination was necessary”

2. Knowledge of doctors about disease/treatment 2 2

3. General opinion waiting room 5 3

4. Attitude of assistant X-ray ward 3 3

5. Attitude of assistant Blood test 3 3

Attitude of doctors 8 -

New and ethnic specific dimensions Outpatient Q

1 new dimension with 2 general items:

Patients' autonomy

“doctor let me decide too”

“doctor asked for permission”

2 ethnic specific dimensions:

Attitude of doctors (take seriously and specific)

Attitude of doctors (time and attention)

Attitude of doctors (take seriously and specific)

Doctor has an open attitude towards my culture

Doctor took my health complains seriously

Doctor tried to understand me

Doctor told bad news tactically

Doctor gave me a feeling to have prejudices

Doctor discriminated

Relation with overall satisfaction

Outpatients questionnaire

Attitude of doctors (take seriously and specific) F 34.763**

Attitude of doctors (time and attention) F 4.857*

Inpatient questionnaire

Welcome on emergency admission F 16.640**

Attitude (in general) of nurses F 11.406**

Attitude (specific) of nurses F 9.308**

Knowledge of nurses about disease/treatment F 8.500**

Information from doctors and nurses on discharge F 8.341**

Information from doctors F 7.815****p 0.01; *p 0.05; Cursive: specific dimensions

Conclusions

Dimensions

Migrant Inpatient and Outpatient Questionnaires valid regarding:

content

construct

criterion

internal reliability

Measuring quality of outpatient and inpatient hospital care

from the perspective of ethnic minorities, valid and reliable,

add ethnic specific items in questionnaire

www.migranthealth.net