Validating a New Tool on Assessment of Fulfilment of Expectations of Patients with Non-Communicable Diseases – An Ordinal Data Analysis Approach
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2017, Vol 2, Issue 5
Abstract
Introduction: Fulfilment of expectations and attitude to treatment in OPD set-up is an important indicator for quality of service delivery, which is even further important for patients with non-communicable diseases (NCDs) since it will lead to better adherence – a key concept in comprehensive management of any NCD. Objectives: The current study was carried out to establish internal consistency reliability &construct validity and dimensionality of the new tool. Methods: The new pre-tested tool had 26 items each being a three-point likert-type item. Temporal method of sampling was followed for interviewing the respondents meeting inclusion and exclusion criteria. Taking an item-to-respondent ratio of 1:5, minimum sample size of 130 was calculated. Internal consistency and construct validity were measured by ordinal Alpha and ordinal Omega coefficients with more emphasis on later. Multiple correspondence analysis (MCA) was performed assuming ordinal level of categorical response for each item using the software R (version 3.3.0). Results: 131 completed responses were analysed. Majority were aged below 40 years, male and Hindu. Diabetes Mellitus and hypertension were the major diagnoses. Ordinal Alpha was 0.67 (95% CI: 0.6 – 0.74) and ordinal Omega (total) was 0.72 (95% CI: 0.65 – 0.79). On MCA 6 dimensions were retained in accordance with the conceptual framework. Time-intensiveness was first dimension as it explained maximum variance (18.28%). The items had relatedness to different dimensions measured by η2 value. Conclusion: The study concluded with strong evidence of internal consistency and construct validity of the tool with ordinal level of items. Items having bearing on multiple dimensions in the MCA solution revealed the relatedness of the dimensions. However, with more resources a multi-centric multi-OPD study can be planned for more precise estimates.
Authors and Affiliations
Dr. Arista Lahiri
Keywords
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