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Published in: BMC Oral Health 1/2023

Open Access 01-12-2023 | Care | Research

Scale development to measure the patient perception of patient-centered care of dentists in primary care settings of Thailand: a measurement invariance test

Authors: Yutthana Khamnil, Surasak Kao-iean, Pagaporn Pantuwadee Pisarnturakit

Published in: BMC Oral Health | Issue 1/2023

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Abstract

Background

Patient-centered care is essential for providing quality services thoroughly at the primary care level, but it is unclear and lacks measurement. This study aimed to develop a reliable and valid instrument to measure patient perception of patient-centered care in primary dental care in Thailand and test the measurement invariance between large and small community hospitals.

Methods

The initial set of 45 items for the patient perception of Patient-Centered Care of Dentist Scale (PCCDS-P version) was developed using a mixed-method approach, which included a literature review, a content validity test, cognitive interviews, and a pre-test. A multistage sampling strategy was used to recruit dental patients or their parents or caregivers from community hospitals across Thailand. Validity was examined through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Reliability was assessed using Cronbach's alpha coefficient and the intraclass correlation coefficient. Furthermore, a multi-group analysis was conducted to compare the responses of patients from large and small community hospitals.

Results

Three hundred thirty-six and One thousand one hundred sixty-seven samples were randomized for EFA and CFA, respectively. The final PCCDS-P version consists of 7 factors with satisfactory reliability and validity and is composed of 42 items: dentist-patient relationship, disease-illness, integrated care, communication, shared information and decision-making, holistic, and empathy and anxiety management. The CFA showed the model fit was consistent with the entire sample. The metric invariance analysis showed that the factor loadings were invariant across patient groups. Overall, Cronbach's alpha coefficient and intraclass correlation coefficient were satisfactory.

Conclusions

The newly developed PCCDS-P version is composed of seven domains with 42 items with good reliability and validity, and it indicated measurement invariance across patients in large and small community hospitals.
Literature
1.
go back to reference Tangcharoensathien V, Witthayapipopsakul W, Panichkriangkrai W, Patcharanarumol W, Mills A. Health systems development in Thailand: a solid platform for successful implementation of universal health coverage. Lancet. 2018;391(10126):1205–23.CrossRefPubMed Tangcharoensathien V, Witthayapipopsakul W, Panichkriangkrai W, Patcharanarumol W, Mills A. Health systems development in Thailand: a solid platform for successful implementation of universal health coverage. Lancet. 2018;391(10126):1205–23.CrossRefPubMed
3.
go back to reference Xu RH, Cheung AWL, Wong ELY. The relationship between patient engagement and health-related quality of life in patients: A cross-sectional study in general outpatient clinic in Hong Kong SAR, China. Patient Prefer Adherence2019. p. 1451–62. Xu RH, Cheung AWL, Wong ELY. The relationship between patient engagement and health-related quality of life in patients: A cross-sectional study in general outpatient clinic in Hong Kong SAR, China. Patient Prefer Adherence2019. p. 1451–62.
4.
go back to reference Jahan F, Siddiqui H. Good Communication between Doctor-Patient Improves Health Outcome. EJMED: European Open Access Publishing (Europa Publishing); 2019.CrossRef Jahan F, Siddiqui H. Good Communication between Doctor-Patient Improves Health Outcome. EJMED: European Open Access Publishing (Europa Publishing); 2019.CrossRef
5.
go back to reference Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington (DC): National Academies Press; 2001. p. 360. Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington (DC): National Academies Press; 2001. p. 360.
6.
go back to reference Ungchusak C, Kaewkhuntee D, Yongvanichakorn B, Liengkobkit S. Oral care delivery by dental nurse at sub-district health centers during 1997–1998. Th Dent PH J. 2001;6(2):75–89. Ungchusak C, Kaewkhuntee D, Yongvanichakorn B, Liengkobkit S. Oral care delivery by dental nurse at sub-district health centers during 1997–1998. Th Dent PH J. 2001;6(2):75–89.
7.
go back to reference Barbara S. Is primary care essential? [Primary Care Tomorrow]. Lancet. 1994;344(8930):1129–33.CrossRef Barbara S. Is primary care essential? [Primary Care Tomorrow]. Lancet. 1994;344(8930):1129–33.CrossRef
8.
go back to reference Mills I, Frost J, Cooper C, Moles DR, Kay E. Patient-centred care in general dental practice - a systematic review of the literature. BMC Oral Health. 2014;14:64.CrossRefPubMedPubMedCentral Mills I, Frost J, Cooper C, Moles DR, Kay E. Patient-centred care in general dental practice - a systematic review of the literature. BMC Oral Health. 2014;14:64.CrossRefPubMedPubMedCentral
9.
go back to reference Scambler S, Delgado M, Asimakopoulou K. Defining patient-centred care in dentistry? A systematic review of the dental literature. Br Dent J. 2016;221:477–84.CrossRefPubMed Scambler S, Delgado M, Asimakopoulou K. Defining patient-centred care in dentistry? A systematic review of the dental literature. Br Dent J. 2016;221:477–84.CrossRefPubMed
10.
go back to reference Alrawiai S, Asimakopoulou K, Scambler S. Patient-Centred Care in Dentistry: Definitions and Models - Commentary. Eur J Dent Educ. 2021;25:637–40.CrossRefPubMed Alrawiai S, Asimakopoulou K, Scambler S. Patient-Centred Care in Dentistry: Definitions and Models - Commentary. Eur J Dent Educ. 2021;25:637–40.CrossRefPubMed
11.
go back to reference Finance Commercial and NHS Directorate. Dental Quality and Outcomes Framework for 2016–17. In: Department of Health, editor. 2016. Finance Commercial and NHS Directorate. Dental Quality and Outcomes Framework for 2016–17. In: Department of Health, editor. 2016.
12.
go back to reference Byrne MJ, Tickle M, Glenny AM, Campbell S, Goodwin T, O’Malley L. A systematic review of quality measures used in primary care dentistry. Int Dent J. 2019;69(4):252–64.CrossRefPubMed Byrne MJ, Tickle M, Glenny AM, Campbell S, Goodwin T, O’Malley L. A systematic review of quality measures used in primary care dentistry. Int Dent J. 2019;69(4):252–64.CrossRefPubMed
13.
go back to reference Righolt AJ, Sidorenkov G, Faggion CM Jr, Listl S, Duijster D. Quality measures for dental care: A systematic review. Community Dent Oral Epidemiol. 2019;47(1):12–23.CrossRefPubMed Righolt AJ, Sidorenkov G, Faggion CM Jr, Listl S, Duijster D. Quality measures for dental care: A systematic review. Community Dent Oral Epidemiol. 2019;47(1):12–23.CrossRefPubMed
14.
go back to reference Corah NL, O’Shea RM, Bissell GD. The dentist-patient relationship: perceptions by patients of dentist behavior in relation to satisfaction and anxiety. J Am Dent Assoc. 1985;111:443–6.CrossRefPubMed Corah NL, O’Shea RM, Bissell GD. The dentist-patient relationship: perceptions by patients of dentist behavior in relation to satisfaction and anxiety. J Am Dent Assoc. 1985;111:443–6.CrossRefPubMed
15.
go back to reference Hurst YK, Prescott-Clements LE, Rennie JS. The patient assessment questionnaire: A new instrument for evaluating the interpersonal skills of vocational dental practitioners. Br Dent J. 2004;197:497–500.CrossRefPubMed Hurst YK, Prescott-Clements LE, Rennie JS. The patient assessment questionnaire: A new instrument for evaluating the interpersonal skills of vocational dental practitioners. Br Dent J. 2004;197:497–500.CrossRefPubMed
16.
go back to reference Gonzales PS, Martins IEF, Biazevic MG, Silva PR, Michel-Crosato E. Dental Management Survey Brazil (DMS-BR): creation and validation of a management instrument. Braz Oral Res. 2017;31: e26.CrossRefPubMed Gonzales PS, Martins IEF, Biazevic MG, Silva PR, Michel-Crosato E. Dental Management Survey Brazil (DMS-BR): creation and validation of a management instrument. Braz Oral Res. 2017;31: e26.CrossRefPubMed
17.
go back to reference Hakeberg M, Heidari E, Norinder M, Berggren U. A Swedish version of the Dental Visit Satisfaction Scale. Acta Odontol Scand: Taylor and Francis A.S.; 2000. 19–24. Hakeberg M, Heidari E, Norinder M, Berggren U. A Swedish version of the Dental Visit Satisfaction Scale. Acta Odontol Scand: Taylor and Francis A.S.; 2000. 19–24.
18.
go back to reference Rozier RG, White BA, Wang M, Meyer BD, Lee JY. Development and testing of a patient-centered dental home assessment for low-income families. J Public Health Dent. 2019;79(3):253–63.CrossRefPubMedPubMedCentral Rozier RG, White BA, Wang M, Meyer BD, Lee JY. Development and testing of a patient-centered dental home assessment for low-income families. J Public Health Dent. 2019;79(3):253–63.CrossRefPubMedPubMedCentral
19.
go back to reference Damiano P, Reynolds J, Herndon JB, McKernan S, Kuthy R. The patient-centered dental home: A standardized definition for quality assessment, improvement, and integration. Health Serv Res. 2019;54(2):446–54.CrossRefPubMed Damiano P, Reynolds J, Herndon JB, McKernan S, Kuthy R. The patient-centered dental home: A standardized definition for quality assessment, improvement, and integration. Health Serv Res. 2019;54(2):446–54.CrossRefPubMed
20.
go back to reference Akbar FH, Awang AH, Rivai F. Effect of Quality of Dental Health Services to Patient Satisfaction in Indonesia 2019: Importance-Performance Analysis. Pesqui Bras Odontopediatria Clin Integr. 2023;23:1–12. Akbar FH, Awang AH, Rivai F. Effect of Quality of Dental Health Services to Patient Satisfaction in Indonesia 2019: Importance-Performance Analysis. Pesqui Bras Odontopediatria Clin Integr. 2023;23:1–12.
21.
go back to reference Akbar FH, Ulfah U, Maretta YA. The Effect of Health Services Quality on Satisfaction and Loyalty in West Sulawesi Province, Indonesia. Open Access Macedonian J Med Sci. 2020;8(D):150–7. Akbar FH, Ulfah U, Maretta YA. The Effect of Health Services Quality on Satisfaction and Loyalty in West Sulawesi Province, Indonesia. Open Access Macedonian J Med Sci. 2020;8(D):150–7.
22.
go back to reference Pholpark A, Pongsupap Y, Aekplakorn W, Srithamrongsawat S, Sunsern R. Responsiveness under different health insurance schemes and hospital types. JHSR. 2012;6(2):207–17. Pholpark A, Pongsupap Y, Aekplakorn W, Srithamrongsawat S, Sunsern R. Responsiveness under different health insurance schemes and hospital types. JHSR. 2012;6(2):207–17.
23.
go back to reference Liabsuetrakul T, Petmanee P, Sanguanchua S, Oumudee N. Health system responsiveness for delivery care in Southern Thailand. Int J Qual Health Care. 2012;24(2):7.CrossRef Liabsuetrakul T, Petmanee P, Sanguanchua S, Oumudee N. Health system responsiveness for delivery care in Southern Thailand. Int J Qual Health Care. 2012;24(2):7.CrossRef
24.
go back to reference Costello AB, Osborne JW. Best Practices in Exploratory Factor Analysis: Four Recommendations for Getting the Most from Your Analysis. PARE. 2005;10:1–9. Costello AB, Osborne JW. Best Practices in Exploratory Factor Analysis: Four Recommendations for Getting the Most from Your Analysis. PARE. 2005;10:1–9.
25.
go back to reference Khamnil Y, Kao-iean S, Pisarnturakit PP. A conceptual construction of patient-centered dental care for primary care dentists in Thailand. Th Dent PH J. 2023;28(1):14–31. Khamnil Y, Kao-iean S, Pisarnturakit PP. A conceptual construction of patient-centered dental care for primary care dentists in Thailand. Th Dent PH J. 2023;28(1):14–31.
27.
go back to reference Polit DF, Beck CT. The content validity index: are you sure you know what’s being reported? Critique and recommendations Res Nurs Health. 2006;29(5):489–97.CrossRefPubMed Polit DF, Beck CT. The content validity index: are you sure you know what’s being reported? Critique and recommendations Res Nurs Health. 2006;29(5):489–97.CrossRefPubMed
28.
go back to reference Knapp TR. Coefficient alpha: conceptualizations and anomalies. Res Nurs Health. 1991;14(6):457–60.CrossRefPubMed Knapp TR. Coefficient alpha: conceptualizations and anomalies. Res Nurs Health. 1991;14(6):457–60.CrossRefPubMed
29.
go back to reference Hu Lt, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Struct Equ Modeling. 1999;6(1):1–55. Hu Lt, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Struct Equ Modeling. 1999;6(1):1–55.
31.
go back to reference Hair JF, Black WC, Babin BJ, Anderson RE. Multivariate Data Analysis 7ed. Upper Saddle River, NJ: Pearson; 2009. Hair JF, Black WC, Babin BJ, Anderson RE. Multivariate Data Analysis 7ed. Upper Saddle River, NJ: Pearson; 2009.
32.
go back to reference Meade AW, Johnson EC, Braddy PW. Power and sensitivity of alternative fit indices in tests of measurement invariance. J Appl Psychol. 2008;93(3):568–92.CrossRefPubMed Meade AW, Johnson EC, Braddy PW. Power and sensitivity of alternative fit indices in tests of measurement invariance. J Appl Psychol. 2008;93(3):568–92.CrossRefPubMed
33.
go back to reference Putnick DL, Bornstein MH. Measurement invariance: Review of practice and implications. HRMR. 2008;18:210–22. Putnick DL, Bornstein MH. Measurement invariance: Review of practice and implications. HRMR. 2008;18:210–22.
34.
go back to reference Koo TK, Li MY. A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research. J Chiropr Med. 2016;15(2):155–63.CrossRefPubMedPubMedCentral Koo TK, Li MY. A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research. J Chiropr Med. 2016;15(2):155–63.CrossRefPubMedPubMedCentral
35.
go back to reference Lei M, Lomax RG. The Effect of Varying Degrees of Nonnormality in Structural Equation Modeling. Struct Equ Modeling. 2005;12(1):1–27.CrossRef Lei M, Lomax RG. The Effect of Varying Degrees of Nonnormality in Structural Equation Modeling. Struct Equ Modeling. 2005;12(1):1–27.CrossRef
36.
go back to reference Matsunaga M. How to Factor-Analyze Your Data Right: Do’s, Don’ts, and How-To’s. IJPR. 2010;3(1):97–110. Matsunaga M. How to Factor-Analyze Your Data Right: Do’s, Don’ts, and How-To’s. IJPR. 2010;3(1):97–110.
37.
go back to reference Scambler S, Asimakopoulou K. A model of patient-centred care-turning good care into patient-centred care. Br Dent J. 2014;217(5):225–8.CrossRefPubMed Scambler S, Asimakopoulou K. A model of patient-centred care-turning good care into patient-centred care. Br Dent J. 2014;217(5):225–8.CrossRefPubMed
38.
go back to reference Noushi N, Bedos C. Developing person-centred dental care: The perspectives of people living in poverty. Dent J. 2020;8(3):2–9.CrossRef Noushi N, Bedos C. Developing person-centred dental care: The perspectives of people living in poverty. Dent J. 2020;8(3):2–9.CrossRef
39.
go back to reference Kulich KR, Berggren U, Hallberg LRM. A Qualitative Analysis of Patient-Centered Dentistry in Consultations with Dental Phobic Patients. J Health Commun. 2003;8(2):171–87.CrossRefPubMed Kulich KR, Berggren U, Hallberg LRM. A Qualitative Analysis of Patient-Centered Dentistry in Consultations with Dental Phobic Patients. J Health Commun. 2003;8(2):171–87.CrossRefPubMed
40.
go back to reference Apelian N, Vergnes J-N, Bedos C. Humanizing clinical dentistry through a person-centred model. Int J Whole Pers Care. 2014;1(2):30–50. Apelian N, Vergnes J-N, Bedos C. Humanizing clinical dentistry through a person-centred model. Int J Whole Pers Care. 2014;1(2):30–50.
41.
go back to reference Naorungroj S, Manuschai J, Wongwiriyapokin K, Ratti P, Chinniyomwanich W, Horwongsakul S. Patient feedback with patient-centered dental care and its association with emotional intelligence: A cross-sectional study in undergraduate dental students at Prince of Songkla University. Songklanakarin Dent J. 2018;6(2):1–11. Naorungroj S, Manuschai J, Wongwiriyapokin K, Ratti P, Chinniyomwanich W, Horwongsakul S. Patient feedback with patient-centered dental care and its association with emotional intelligence: A cross-sectional study in undergraduate dental students at Prince of Songkla University. Songklanakarin Dent J. 2018;6(2):1–11.
42.
go back to reference Damiano PC, Reynolds JC, Mckernan SC. The need for defining a patient-centered dental home model in the era of the Affordable Care Act Background Report. The University of Iowa Health Policy center; 2015. Damiano PC, Reynolds JC, Mckernan SC. The need for defining a patient-centered dental home model in the era of the Affordable Care Act Background Report. The University of Iowa Health Policy center; 2015.
43.
go back to reference Hunsrisakhun J. Holistic Care in Dentistry Concept towards Clinical Practices. J Dent Assoc Thai. 2010;60(4):293–304. Hunsrisakhun J. Holistic Care in Dentistry Concept towards Clinical Practices. J Dent Assoc Thai. 2010;60(4):293–304.
44.
go back to reference Mills I, Frost J, Kay E, Moles DR. Person-centred care in dentistry - The patients’ perspective. Br Dent J. 2015;218(7):407–13.CrossRefPubMed Mills I, Frost J, Kay E, Moles DR. Person-centred care in dentistry - The patients’ perspective. Br Dent J. 2015;218(7):407–13.CrossRefPubMed
45.
go back to reference Loignon C, Allison P, Landry A, Richard L, Brodeur JM, Bedos C. Providing humanistic care: Dentists experiences in deprived areas. J Dent Res. 2010;89(9):991–5.CrossRefPubMed Loignon C, Allison P, Landry A, Richard L, Brodeur JM, Bedos C. Providing humanistic care: Dentists experiences in deprived areas. J Dent Res. 2010;89(9):991–5.CrossRefPubMed
46.
go back to reference Apelian N, Vergnes JN, Hovey R, Bedos C. How can we provide person-centred dental care? Br Dent J. 2017;223:419–24.CrossRefPubMed Apelian N, Vergnes JN, Hovey R, Bedos C. How can we provide person-centred dental care? Br Dent J. 2017;223:419–24.CrossRefPubMed
48.
go back to reference Detsomboonrat P, Theppanich S, Banyen S, Hongviphat S, Khamnil Y, Lapauthaya K, et al. Empathy level towards patients among thai dental students: a cross-sectional study. BMC Oral Health. 2023;23(1):184.CrossRefPubMedPubMedCentral Detsomboonrat P, Theppanich S, Banyen S, Hongviphat S, Khamnil Y, Lapauthaya K, et al. Empathy level towards patients among thai dental students: a cross-sectional study. BMC Oral Health. 2023;23(1):184.CrossRefPubMedPubMedCentral
49.
go back to reference Chongkonsatit W, Wongsinphaibon N, Kurupakorn A, Urairoekkun K, Noimanee K. 7Cs marketing mix factors in a dental school comprehensive care clinic: A confirmatory factor analysis. M Dent J. 2022;42(1):13–24. Chongkonsatit W, Wongsinphaibon N, Kurupakorn A, Urairoekkun K, Noimanee K. 7Cs marketing mix factors in a dental school comprehensive care clinic: A confirmatory factor analysis. M Dent J. 2022;42(1):13–24.
Metadata
Title
Scale development to measure the patient perception of patient-centered care of dentists in primary care settings of Thailand: a measurement invariance test
Authors
Yutthana Khamnil
Surasak Kao-iean
Pagaporn Pantuwadee Pisarnturakit
Publication date
01-12-2023
Publisher
BioMed Central
Keyword
Care
Published in
BMC Oral Health / Issue 1/2023
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/s12903-023-03331-1

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