Structural validity and internal consistency of the Patient Centred Assessment Method in a primary care setting in a Japanese island area: a cross-sectional study

Objectives The objective of this study was to examine the structural validity and internal consistency of the original English version of the Patient Centred Assessment Method (PCAM) in a primary care setting in a Japanese island area.Design Cross-sectional study.Setting A clinic on a remote island...

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Main Authors: Masato Matsushima, Shuhei Yoshida, Rieko Mutai, Yoshifumi Sugiyama, Ryoko Horiguchi, Hisashi Yoshimoto
Format: Article
Language:English
Published: BMJ Publishing Group 2022-06-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/12/6/e050566.full
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author Masato Matsushima
Shuhei Yoshida
Rieko Mutai
Yoshifumi Sugiyama
Ryoko Horiguchi
Hisashi Yoshimoto
author_facet Masato Matsushima
Shuhei Yoshida
Rieko Mutai
Yoshifumi Sugiyama
Ryoko Horiguchi
Hisashi Yoshimoto
author_sort Masato Matsushima
collection DOAJ
description Objectives The objective of this study was to examine the structural validity and internal consistency of the original English version of the Patient Centred Assessment Method (PCAM) in a primary care setting in a Japanese island area.Design Cross-sectional study.Setting A clinic on a remote island in Okinawa, Japan, that provides general outpatient and 24-hour emergency services.Participants This study included 355 patients who visited Tarama Clinic from 1 April 2018 to 30 June 2018, were aged ≥20 years, lived in Tarama Village and had decision-making capacity.Main outcome measures Patient complexity scored by the PCAM.Results The mean (SD) PCAM score was 21.4 (5.7). The distribution was skewed to the right and there were no ceiling and floor effects. Confirmatory factor analysis found that the previously reported two-factor and three-factor structures did not show a good fit (root mean square error of approximation 0.18 and 0.16, comparative fit index 0.83 and 0.89 and standardised root mean square residual 0.14 and 0.11, respectively). Exploratory factor analysis revealed a new two-factor structure: ‘Biomedical complexity’ and ‘Psychosocial complexity’. The Cronbach’s alpha values for the total PCAM score, the ‘Biomedical complexity’ factor, and the ‘Psychosocial complexity’ factor were 0.81, 0.82 and 0.74, respectively.Conclusions In this study, confirmatory factor analysis found that the data did not fit sufficiently using the previously reported two-factor and three-factor structures. Instead, exploratory factor analysis revealed a new two-factor structure, for which the Cronbach’s alpha values exceeded the threshold level. Therefore, the structural validity and internal consistency of the English version of the PCAM were verified in a primary care setting in a Japanese island area.
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spelling doaj-art-27f570588b9d40b38b57bfd1deca77292025-01-27T13:50:11ZengBMJ Publishing GroupBMJ Open2044-60552022-06-0112610.1136/bmjopen-2021-050566Structural validity and internal consistency of the Patient Centred Assessment Method in a primary care setting in a Japanese island area: a cross-sectional studyMasato Matsushima0Shuhei Yoshida1Rieko Mutai2Yoshifumi Sugiyama3Ryoko Horiguchi4Hisashi Yoshimoto51 Division of Clinical Epidemiology, Jikei University School of Medicine, Minato-ku, Tokyo, JapanDepartment of Community-Based Medical System, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Hiroshima, JapanDepartment of Adult Nursing, The Jikei University School of Nursing, Chofu, Tokyo, Japan3 Division of Clinical Epidemiology, Research Center for Medical Sciences, Jikei University School of Medicine, Minato-ku, Tokyo, JapanDivision of Clinical Epidemiology, Research Center for Medical Sciences, The Jikei University School of Medicine, Minato-ku, Tokyo, JapanDepartment of Family Medicine, General Practice and Community Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, JapanObjectives The objective of this study was to examine the structural validity and internal consistency of the original English version of the Patient Centred Assessment Method (PCAM) in a primary care setting in a Japanese island area.Design Cross-sectional study.Setting A clinic on a remote island in Okinawa, Japan, that provides general outpatient and 24-hour emergency services.Participants This study included 355 patients who visited Tarama Clinic from 1 April 2018 to 30 June 2018, were aged ≥20 years, lived in Tarama Village and had decision-making capacity.Main outcome measures Patient complexity scored by the PCAM.Results The mean (SD) PCAM score was 21.4 (5.7). The distribution was skewed to the right and there were no ceiling and floor effects. Confirmatory factor analysis found that the previously reported two-factor and three-factor structures did not show a good fit (root mean square error of approximation 0.18 and 0.16, comparative fit index 0.83 and 0.89 and standardised root mean square residual 0.14 and 0.11, respectively). Exploratory factor analysis revealed a new two-factor structure: ‘Biomedical complexity’ and ‘Psychosocial complexity’. The Cronbach’s alpha values for the total PCAM score, the ‘Biomedical complexity’ factor, and the ‘Psychosocial complexity’ factor were 0.81, 0.82 and 0.74, respectively.Conclusions In this study, confirmatory factor analysis found that the data did not fit sufficiently using the previously reported two-factor and three-factor structures. Instead, exploratory factor analysis revealed a new two-factor structure, for which the Cronbach’s alpha values exceeded the threshold level. Therefore, the structural validity and internal consistency of the English version of the PCAM were verified in a primary care setting in a Japanese island area.https://bmjopen.bmj.com/content/12/6/e050566.full
spellingShingle Masato Matsushima
Shuhei Yoshida
Rieko Mutai
Yoshifumi Sugiyama
Ryoko Horiguchi
Hisashi Yoshimoto
Structural validity and internal consistency of the Patient Centred Assessment Method in a primary care setting in a Japanese island area: a cross-sectional study
BMJ Open
title Structural validity and internal consistency of the Patient Centred Assessment Method in a primary care setting in a Japanese island area: a cross-sectional study
title_full Structural validity and internal consistency of the Patient Centred Assessment Method in a primary care setting in a Japanese island area: a cross-sectional study
title_fullStr Structural validity and internal consistency of the Patient Centred Assessment Method in a primary care setting in a Japanese island area: a cross-sectional study
title_full_unstemmed Structural validity and internal consistency of the Patient Centred Assessment Method in a primary care setting in a Japanese island area: a cross-sectional study
title_short Structural validity and internal consistency of the Patient Centred Assessment Method in a primary care setting in a Japanese island area: a cross-sectional study
title_sort structural validity and internal consistency of the patient centred assessment method in a primary care setting in a japanese island area a cross sectional study
url https://bmjopen.bmj.com/content/12/6/e050566.full
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