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      Patient-centered care and patient satisfaction: Validating the patient-professional interaction questionnaire in China

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          Abstract

          Objective

          To introduce patient-centered approach in China and to relate it with Chinese patient satisfaction via validating the Chinese version of Patient-Professional Interaction Questionnaire (PPIQ-C).

          Design

          This cross-sectional survey was conducted through face-to-face interviews from June to September in 2019. Participants rated their patient-centered care experience via the 16-item translated PPIQ, their experience of the received medical service, and their overall satisfaction.

          Setting

          Kunshan Huaqiao People's Hospital in Jiangsu, China.

          Participants

          A total of 230 participants (87 males and 143 females; 108 outpatients and 122 inpatients).

          Results

          PPIQ-C exhibited acceptable psychometric properties. Data revealed a single factor model of the 16 PPIQ-C items [ χ ( 4 ) 2 = 12.394, p = 0.823, CFI = 1.000, TLI = 1.019, RMSEA = 0.000, SRMR = 0.032] had a superior model fit over the original first-order with four correlated factors and the second-order structures. The overall reliability was excellent (McDonald's ω = 0.975). In terms of patient satisfaction, process, treatment quality, and communication significantly predicted patient satisfaction, while environment, staff attitude, and medical ethics did not [ R 2 = 0.427, F (6) = 24.887, p < 0.001]. Most importantly, the total score of PPIQ-C predicted patient satisfaction above and beyond the above-mentioned medical service perspectives ( B = 0.595, SE = 0.207, p = 0.004). Finally, the constructive effect of PCC on patient satisfaction was stronger for departments of Pediatrics than Surgery.

          Conclusions

          The Chinese version of the PPIQ scale (PPIQ-C) exhibited acceptable psychometric properties. Yet the distinction among the four factors was not supported, suggesting potential difference(s) across cultures. Patient-centered care (PCC), reflected by the overall PPIQ-C score, predicted overall patient satisfaction above and beyond other medical service perspectives. Adopting PCC approach in appropriate situations will probably advance the development of performance evaluation systems in China, thus improving the overall health care and patient satisfaction.

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            Comparative fit indexes in structural models.

            P. M. Bentler (1990)
            Normed and nonnormed fit indexes are frequently used as adjuncts to chi-square statistics for evaluating the fit of a structural model. A drawback of existing indexes is that they estimate no known population parameters. A new coefficient is proposed to summarize the relative reduction in the noncentrality parameters of two nested models. Two estimators of the coefficient yield new normed (CFI) and nonnormed (FI) fit indexes. CFI avoids the underestimation of fit often noted in small samples for Bentler and Bonett's (1980) normed fit index (NFI). FI is a linear function of Bentler and Bonett's non-normed fit index (NNFI) that avoids the extreme underestimation and overestimation often found in NNFI. Asymptotically, CFI, FI, NFI, and a new index developed by Bollen are equivalent measures of comparative fit, whereas NNFI measures relative fit by comparing noncentrality per degree of freedom. All of the indexes are generalized to permit use of Wald and Lagrange multiplier statistics. An example illustrates the behavior of these indexes under conditions of correct specification and misspecification. The new fit indexes perform very well at all sample sizes.
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              Significance tests and goodness of fit in the analysis of covariance structures.

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                Author and article information

                Contributors
                Journal
                Journal ID (nlm-ta): Front Public Health
                Journal ID (iso-abbrev): Front Public Health
                Journal ID (publisher-id): Front. Public Health
                Title: Frontiers in Public Health
                Publisher: Frontiers Media S.A.
                ISSN (Electronic): 2296-2565
                Publication date (Electronic): 07 November 2022
                Publication date Collection: 2022
                Volume: 10
                Electronic Location Identifier: 990620
                Affiliations
                [1] 1School of Public Health, Shanghai Jiao Tong University School of Medicine , Shanghai, China
                [2] 2Kunshan Huaqiao People's Hospital , Kunshan, China
                [3] 3Department of Business Information and Technology, Fogelman College of Business and Economics, University of Memphis , Memphis, TN, United States
                Author notes

                Edited by: Antonio Giulio de Belvis, Catholic University of the Sacred Heart, Italy

                Reviewed by: Lukas Novak, Olomouc University Social Health Institute (OUSHI), Czechia; Paola Gremigni, University of Bologna, Italy

                *Correspondence: Zhiruo Zhang zhangzhiruo@ 123456sjtu.edu.cn

                This article was submitted to Public Health Policy, a section of the journal Frontiers in Public Health

                †These authors have contributed equally to this work and share first authorship

                Article
                DOI: 10.3389/fpubh.2022.990620
                PMC ID: 9676965
                PubMed ID: 36420009
                SO-VID: b79a67d7-0a94-416e-81a4-5648db534b38
                Copyright © Copyright © 2022 Han, Li, Li, Yu, Li, Jing, Bai, Fang, Qian, Li, Liang and Zhang.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                Date received : 10 July 2022
                Date accepted : 21 October 2022
                Page count
                Figures: 1, Tables: 5, Equations: 0, References: 41, Pages: 9, Words: 5612
                Categories
                Subject: Public Health
                Subject: Hypothesis and Theory

                Keywords: patient-centered care,pcc,patient-professional interaction questionnaire,ppiq,patient satisfaction,chinese patient satisfaction,china
                Data availability:
                Keywords: patient-centered care, pcc, patient-professional interaction questionnaire, ppiq, patient satisfaction, chinese patient satisfaction, china

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