Validation of the measure of processes of care for adults: a measure of client-centred care

OBJECTIVE: To assess the psychometric properties of the measure of processes of care for adults (MPOC-A), a measure of client-centredness of care for parents of children with disabilities, adapted for adult health-care settings. DESIGN: A validation study. SETTING: Regional orthopaedic service of a university-affiliated hospital in ON, Canada. PARTICIPANTS: All patients and families who had had joint replacement surgery (Knee or Hip) between January and August of 2007. MAIN OUTCOME MEASURES: MPOC-A and the client satisfaction questionnaire (CSQ). RESULTS: One hundred and seventy-six questionnaires filled out by patients and 81 by family members were analysed. Scales demonstrated high internal consistency (Cronbach's alpha varying from 0.81 to 0.93 for patients and from 0.88 to 0.96 for family members). MPOC-A domain scores were moderately correlated with CSQ total scores (Pearson coefficients varying from 0.44 to 0.66 for patients and from 0.53 to 0.72 for family members). Moderate to good inter-rater agreement [intraclass correlation coefficient (ICC) from 0.50 to 0.74] and high test-retest reliability were found (ICCs varying from 0.73 to 0.83 for patients and from 0.75 to 0.91 for family members). CONCLUSIONS: MPOC-A has demonstrated good psychometric properties. As general satisfaction scores are notoriously poor indicators of the quality of care, this measure can help us understand the elements that contribute to overall judgements of satisfaction and provide a level of understanding that is important to improve service quality and delivery.