Translation and validation of the Patient-Practitioner Orientation Scale in Turkey

Yıl 2018, , 21 - 32, 30.04.2018

Serdar Özdemir , Tamer Edirne

https://doi.org/10.25282/ted.350121

Cited By: 1

Öz

Background: The Patient-Practitioner
Orientation Scale is designed to compare a patient-oriented approach with a
doctor-oriented approach among medical personnel.

Aims: The aim of this study is to adapt the Patient-Practitioner Orientation Scale
to Turkish. The hypotheses that the Turkish version shows linguistic
equivalence and comparable validity, reliability and factor load were tested.

Study design: This descriptive correlational study describes the translation process and
exploratory and confirmatory factor analyses of the Patient-Practitioner
Orientation Scale.

Methods: The original scale was first translated into Turkish using translation-back
translation method. Linguistic equivalence was tested by bilingual groups
design through conducting the scale to English speaking first term medical
students and comparing original and target scale items by Spearman correlation
coefficient. Medical
students (n=379) from two medical schools in Turkey were enrolled in the study
to complete the Turkish scale in order to test validity and reliability. Exploratory and confirmatory factor analyses were
completed to evaluate structure validity. Cronbach Alpha values were defined
for internal consistency.

Results: Items in the Turkish version compared to the
original scale items showed a relation between 0.41 and 0.71 (p<0,01) verifying
linguistic equivalence. Primary exploratory factor analysis revealed that four
items did not achieve a loading factor of 0.30 and these items were
excluded.  After
factor analysis and tests of internal consistency, a shortened version with 14
items was formed (PPOS - T14). Cronbach’s alpha coefficients were 0.800 for the entire sample group, 0.732
for the sharing domain and 0.653 for the caring domain and were found adequate.

Conclusions: The Turkish form
of the PPOS showed linguistic equivalence, satisfactory validity and acceptable
reliability. PPOS - T14 is a reliable tool to
evaluate patient-centeredness between medical students in Turkish-speaking
countries.

Anahtar Kelimeler

Patient doctor relationship, patient centeredness, validity, reliability

Hasta-Hekim Yönelim Ölçeğinin (HHYÖ) Türkçeye uyarlanması

Öz

Amaç

Bu çalışmada orijinal ismi The
Patient–Practitioner Orientation Scale olan Hasta-Hekim Yönelim Ölçeğinin
(HHYÖ) Türkçeye uyarlanması amaçlanmıştır. Buna göre ölçeğin Türkçe formunun
orijinal İngilizce form ile dilsel eşdeğerlik taşıdığı, benzer geçerlik,
güvenirlik ve faktör yapısına sahip olduğu hipotezleri sınanmıştır.

 

Yöntem

Araştırmada öncelikle 18 maddeden oluşan
ölçek çeviri-geri çeviri yöntemi ile Türkçeye çevrilmiştir. Çevirinin dilsel
eşdeğerliği iki dilli grup deseni kullanılarak test edilmiştir. Bunun için
İngilizce bilen tıp fakültesi öğrencilerine (n=71) test-tekrar test yöntemine
göre uygulanan ölçeğin kaynak ve hedef dildeki maddeleri arasındaki
ilişkiler Spearman korelasyon katsayısı ile incelenmiştir. Geçerlik ve
güvenirlik analizleri için Türkçe ölçek iki farklı tıp fakültesindeki 1. sınıf
öğrencilerine  (n=379) uygulanmıştır. Ölçeğin
yapı geçerliğini ortaya koymak amacıyla Açımlayıcı Faktör Analizi ve
Doğrulayıcı Faktör Analizi yapılmıştır. Güvenirlik analizi Cronbach Alfa iç
tutarlılık katsayısı hesaplanarak yapılmıştır.

 

Sonuçlar

Hasta Hekim İlişkisine Yönelik
Tutum Ölçeğinde yer alan maddelerin orijinal maddeler ile 0.41 ile 0.71
arasında (p<0,01) anlamlı dilsel eşdeğerlik gösterdikleri saptanmıştır. İlk
açımlayıcı faktör analizinde faktörlerin içerisine oturmayan ve faktör
ağırlıkları 0,25’den düşük olarak saptanan dört madde dışarıda bırakılmıştır.
Geriye kalan 14 madde ile yapılan ikinci analizin sonucuna göre Türkçe
maddelerin orijinal ölçekte yer alan maddeler ile benzer yük aldıkları
görülmüştür. Ölçeğin toplam Cronbach Alfa değeri 0.80, paylaşım alt boyutu için
bu değer 0,732; bakım alt boyutu için ise 0,653 hesaplanmış ve kabul edilebilir düzeyde
bulunmuştur.

 

Tartışma

Bu sonuçlara göre Hasta-Hekim
Yönelim Ölçeğinin Türkiye’deki araştırmalarda kullanılabilecek, dilsel eşdeğerliğe sahip,
geçerli ve güvenilir bir ölçme aracı olduğu söylenebilir.

Anahtar Kelimeler

Hasta hekim ilişkisi, hasta merkezli yaklaşım, geçerlik

Kaynakça

• 1. Balint E. The possibilities of patient-centered medicine. J R Coll Gen Pract 1969;17(82):269-76. 2. Hudon C, Fortin M, Haggerty JL, Lambert M, Poitras ME. Measuring patients’ perceptions of patient-centered care: A systematic review of tools for family medicine. Ann Fam Med 2011;9:155-64. 3. Stewart M. Towards a global definition of patient-centred care. Br Med J 2001;322:444–5. 4. Robinson JH, Callister LLC, Berry JA, Dearing KA. Patient-centered care and adherence: Definitions and applications to improve outcomes. J Am Acad Nurse Pract 2008;20:600-7. 5. Stewart M, Brown JB, Donner A, McWhinney IR, Oates J, Weston WW, et al. The impact of patient-centered care on outcomes. J Fam Pract 2000;49(9):796-804. 6. Levinson W, Lesser CS, Epstein RM. Developing physician communication skills for patient-centered care. Health Affair (Millwood) 2010;29:1310–8. 7. Krupat E, Hiam CM, Fleming MZ, Freeman P. Patient-centeredness and its correlates among first year medical students. Int J Psychiatry Med 1999;29(3):347-56. 8. Moore M. What does Patient-centred communication mean in Nepal? Med Educ 2008;42:18-26. 9. Tsimitou Z, Kerasidou O, Efstathiou N, Papaharitou S, Hatzimouratidis K, Hatzichristou D. Medical students’ attitudes toward patient-centered care: A longitudinal survey. Med Educ 2007;41:146-53. 10. Madhan B, Rajpurohit AS, Gayathri H. Attitudes of postgraduate orthodontic students in India towards patient-centred care. J Dent Educ 2011;75(1):107-14. 11. Eremenco SL, Cella D, Arnold BJA. Comprehensive method for the translation and cross-cultural validation of health status questionnaires. Eval Health Prof 2005;28:212–32. 12. Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J, et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol 2007;60:34-42. 13. Hambleton RK, Merenda PF, Spielberger CD. Adapting Educational and Psychological Tests for Cross-Cultural Assessment. New Jersey, London, Lawrence Erlbaum Assoc., Publishers, 2005. 14. Hair JF, Tatham RL, Anderson RE, Black W. Multivariate data analysis, 6th ed., New Jersey: Prentice Hall; 2006. 15. Howell DC. Statistical Methods for Psychology. Florence: Cengage Learning Services, 2009. 16. Coakes SJ, Steed LG. SPSS Analysis without Anguish: Version 14.0 for Windows. Milton, Queensland: John Wiley & Sons Australia Ltd., 2007. 17. Kahn JH. Factor analysis in counseling psychology research, training, and practice: principles, advances, and applications. Couns Psychol 2006;34: 684–718. 18. Hooper, D., Coughlan, J. and Mullen, M. R. Structural Equation Modelling: Guidelines for Determining Model Fit. Electronic Journal of Business Research Methods 2008;6(1):53–60. (cited 12 May 2016) Available from: http://arrow.dit.ie/cgi/viewcontent.cgi?article=1001&context=buschmanart 19. Weston R, Gore PA. A brief guide to structural equation modeling. Couns Psychol 2006;34:684–718. 20. Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J, Bouter LM, de Vet HC. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol 2007;60(1):34-42. 21. Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measure. Spine 2005;25:3186–3191. 22. George D, Mallery P. SPSS for Windows step by step: A simple guide and reference. 11.0 update (4th ed.). Boston: Allyn & Bacon, 2003. 23. McKinley RK, Manku Scott T, Hastings AM, French DP, Baker R. Reliability and validity of a new measure of patient satisfaction with out of hours primary medical care in the United Kingdom: development of a patient questionnaire. BMJ 1997;314:193–8. 24. Bosma H, Marmot MG, Hemingway H, Nicholson AC, Brunner E, Stansfield SA. Low job control and risk of coronary heart disease in Whitehall II (prospective cohort) study. BMJ 1997; 314:558–65. 25. Pereira CM, Amaral CF, Ribeiro MM, Paro HB, Pinto RM, Reis LE, Silva CH, Krupat E. Cross-cultural validation of the Patient–Practitioner Orientation Scale (PPOS). Patient Educ Couns 2013;91:37-43. 26. Mudiyanse RM, Pallegama RW, Jayalath T, Dharmaratne S, Krupat E. Translation and validation of Patient-Practitioner Orientation Scale in Sri-Lanka. Education for Health 2015;28(1):35-40. 27. Kiessling C, Fabry G, Rudolf Fischer M, Steiner C, Langewitz WA. German translation and construct validation of the Patient-Provider-Orientation Scale (PPOS-D12). Psychother Psychosom Med Psychol 2014;64:122-7. doi:10.1055/s-0033-1341455. 28. Green SB, Lissitz RW, Mulaik SA. Limitations of coefficient alpha as an index of test unidimensionality. Educ Psychol Meas. 1977;37:827–38. 29. Cortina JM. What is coefficient alpha: an examination of theory and applications.J Appl Psychol. 1993;78:98–104.