Development and validation of continuity measures for inpatients receiving rehabilitation care

Abstract

Objective: The main goal of this study was to exemplify the development of a measure of continuity of care (COC) from inpatients’ perspective. This measure is focused on several aspects related to physiotherapy.
Methods: A cross-sectional self-report based psychometric study was carried out in a public hospital in southeast Spain. One hundred and fifty two patients with neurological and orthopaedic disorders who received rehabilitation care during stay at hospital were included in the study. A self-report questionnaire was used to examine experiences of patients related to the three types of COC, relational, management and informational continuity. The questionnaire also includes questions about sociodemographic characteristics, patient/therapist affiliation and trust with therapist. To examine reliability were used test-retest and internal consistency. For validation analysis, there were used convergent and known group strategies.
Results: Of the 19 indicators included, 13 were selected to demonstrate adequate reliability and validity. From these indicators were generated three composite measures (Relational, management and COC index) and one individual measure (Informational continuity). Test-retest reliability indicated excellent agreement (intraclass correlation coefficient [ICC] > 0.75) for the three indexes. The range of Cronbach’s value was from 0.60 to 0.73. Total scores of all the indexes were moderately correlated with the satisfaction scale (r > 0.30). Regarding the known groups, all indexes scores were similar for men and woman. However, significant differences were found for management index and for relational index, based on trust with therapist and patient/therapist affiliation, respectively.
Conclusions: The continuity self-reported measures is a valid and reliable method to assessing the COC in hospitalized patients receiving physiotherapy.