Open Access Open Access  Restricted Access Subscription or Fee Access

Validation of the Patient Assessment of Chronic Illness Care (PACIC) Instrument in the Republic of Srpska, Bosnia and Herzegovina

Natasa Pilipovic-Broceta, Nadja Vasiljevic, Jelena Marinkovic, Nevena Todorovic, Janko Jankovic, Irena Ostric, Dimitra Kalimanovska-Ostric, Maja Racic

Abstract


Rationale, aims and objectives: To translate, culturally adapt and preliminary validate the original English version of the PACIC questionnaire into the Serbian language, in the Republic of Srpska, Bosnia and Herzegovina and to assess the relationship between PACIC scores and clinical guidelines implementation in family medicine.

Methods: A cross-sectional study was implemented in 2 primary healthcare centers. The translated PACIC questionnaire was administered to 206 consecutive patients with hypertension, diabetes mellitus and/or chronic obstructive pulmonary disease. The validity and reliability of the Serbian version of PACIC has been tested with face validity, construct validity and internal consistency. The PACIC score and its 5 subscales were tested using Kruskal-Wallis or Mann-Whitney test. The relationship of the PACIC score and guidelines implementation was analyzed by multiple linear regression.

Results: The overall PACIC score indicates an implementation of the Chronic Care Model (CCM) occurred “most of the time”. Of the 5 subscales, average scores were highest on “Delivery system/decision support”. CCM in “Follow up/Coordination” occurred sometimes. Cronbach’s alpha coefficient showed a high internal consistency level for the PACIC questionnaire. Kaiser-Meyer-Olkin Measure of Sampling Adequacy is 0.917 and Bartlett’s test of sphericity is significant (p≤0.001). Four factors were identified explaining 69% of total variance.

Conclusions: There was a significant relationship between the PACIC score and the implementation of the chronic disease clinical guidelines. The PACIC questionnaire is advanced as a reliable and internally consistent instrument of use in increasing the person-centeredness of care of chronic illness.


Keywords


Chronic Care Model (CCM), chronic diseases, cultural adaptation, family medicine, healthcare quality, implementation, PACIC, person-centered healthcare, translation, validation

Full Text:

PDF

References


World Health Organization. (2014). Global status report on noncommunicable diseases 2014. Available at: http://www.who.int/nmh/publications/ncd-status-report-2014/en/Accessed January 23, 2017.

Public Health Institute of Republic of Srpska. (2014). Analysis of Population Health in Republic of Srpska, 2014. Available at: http://www.phi.rs.ba/pdf/publikacije/publikacija_zdr_stanje_2014.pdf. Accessed May 22, 2015.

Popović Pejičić, S., Stoisavljević-Šatara, S., Tešanović, G., Bukara Radujković ,G., Stanetić, K. & Vuković, B. Bolesti žlijezda sa unutrašnjim lučenjem, ishrane i metabolizma. Diabetes mellitus. Available at: http://porodicnamedicina.com/download/klinički_vodici/Bolesti_žlijezda_sa_unutrašnjim_lučenjem.html. Accessed May 22, 2015.

Houle, J., Beaulieu, M.D., Lussier, M.T., Del Grande, C., Pellerin, J.P., Authier, M., Duplain, R., Tran, T.M. & Allisin, F. (2012). Patients’ experience of chronic illness care in a network of teaching settings. Canadian Family Physician 58 (12) 1366-1373.

Glasgow, E.R., Wagner, H.E., Schaefer, J., Mahoney, D.L., Reid, J.R. & Greene, M.S. (2005). Development and Validation of the Patient Assessment of Chronic Illness Care (PACIC). Medical Care 43, 436-444.

Strickland, A.P., Hudson, V.S., Piasecki, A., Hahn, K., Cohen, D., Orzano, A.J., Parchman, M.L. & Crabtree, B.F. (2010). Features of the Chronic Care Model (CCM) Associated with Behavioral Counseling and Diabetes Care in Community Primary Care. Journal of the American Board of Family Medicine 23 (3) 295-305.

Aragones, A., Schaefer, E.W., Stevens, D., Gourevitch, M.N., Glasgow, R.E. & Shah, N.R. (2008). Validation of the Spanish translation of the Patient Assessment of Chronic Illness Care (PACIC) survey. Preventing Chronic Disease 5, 1-10.

Ministry of Health and Social Welfare of the Republic of Srpska. The Primary Health Care Strategy. Available at: http://www.vladars.net/sr-SP-Cyrl/Vlada/Ministarstva/MZSZ/Documents/Primarna%20zastita%20Brosura.pdf. Accessed September 1, 2016.

Janjić, B., Stoisavljević-Šatara, S., Vulić, D. & Martinović Đ. Oboljenja kardiovaskularnog sistema. Arterijska hipertenzija. Available at: http://porodicnamedicina.com/download/klinički_vodici/Oboljenja-kardiovaskularnog-sistema/ArterijskaHipertenzija.pdf.Accessed May 22, 2015.

Petrović, V., Stanetić, M., Stoisavljević-Šatara, S., Martinović, Đ. Oboljenja respiratornog sistema. Nespecificne infekcije u pulmologiji. Available at: http://porodicnamedicina.com/download/klinički_vodici/Oboljenja-respiratornog-sistema/Nespecificne InfekcijeUPulmologiji.pdf. Accessed May 22, 2015.

World Health Organization. Process of translation and adaptation of instruments. Available at: http://www.who.int. Accessed March 26, 2015.

Krucien, N., Le Vaillant, M. & Pelletier-Fleury, N. (2014). Adaptation and validation of the patient assessment of chronic illness care in the French context. BMC Health Services Research 14, 269.

Tusek-Bunc, K., Petek-Ster, M., Ster, B., Petek, D. & Kersnik, J. (2014). Validation of the Slovenian Version of Patient Assessment of Chronic Illness Care (PACIC) in Patients with Coronary Heart Disease. Collegium Antropologicum 38, 437-444.

Wensing, M., van Lieshout, J., Jung, P.H., Hermsen, J. & Rosemann, T. (2008). The Patients Assessment Chronic Illness Care (PACIC) questionnaire in The Netherlands: a validation study in rural general practice. BMC Health Services Research 8, 182.

Rick, J., Rowe, K., Hann, M., Sibbald, B., Reeves, D., Roland, M. & Bower, P. (2012). Psychometric properties of the patient assessment of chronic illness care measure: acceptability, reliability and validity in United Kingdom patients with long-term conditions. BMC Health Services Research 12, 293.

Horodnic, V.A. & Încalţărău, C. (2014). Chronic care model particularities in a healthcare system undergoing transition: pilot study for validating the older Romanian patient assessment of chronic illness care (RO-PACIC). Revista Romana De Bioetica 12, 65-83.

Petersen, J.J., Paulitsch, A.M., Mergenthal, K. et al. (2014). Implementation of chronic illness care in German primary care practices – how do multimorbid older patients view routine care? A cross-sectional study using multilevel hierarchical modeling. BMC Health Services Research 14, 336.

Carryer, J., Budge, C. & Francis, H. (2016). Measuring care alignment in general practice consultations for people with long-term conditions: an exploratory study. Journal of Primary Health Care 8, 256-262.

Koley, M., Saha, S., Ghosh, S., Nag, G., Kundu, M., Mondal, R., Purkait, R., Patra, S. & Ali, S.S. (2016). Patient-Assessed Chronic Illness Care (PACIC) scenario in an Indian homeopathic hospital. Journal of Traditional and Complementary Medicine 6 (1) 72-77.

RS Official Gazette 106/09. Available at: https://www.rgurs.org/en/zakonska-regulativa. Accessed January 24, 2017.

Agency for certification, accreditation and health care improvement of the Republic of Srpska. Available at: https://www.askva.org/en/agency.html. Accessed January 24, 2017.

Gensichen, J., Serras, A., Paulitsch, M.A., Rosemann, T., König, J., Gerlach, F.M. & Petersen, J.J. (2011). The Patient Assessment of Chronic Illness Care Questionnaire: Evaluation in Patients with Mental Disorders in Primary Care. Community Mental Health Journal 47 (4) 447-453.

Gugiu, C., Coryn, L.S. & Applegate, B. (2008). Structure and measurement properties of the Patient Assessment of Chronic Illness Care instrument. Journal of Evaluation in Clinical Practice 16, 509-516.

Ludt, S., van Lieshout, J., Campbell, S.M., Rochon, J., Ose, D., Freund, T., Wensing, M. & Szecsenyi, J. (2012). Identifying factors associated with experiences of coronary heart disease patients receiving structured chronic care and counselling in European primary care. BMC Health Services Research 12, 221.




DOI: http://dx.doi.org/10.5750/ejpch.v6i1.1368

Refbacks

  • There are currently no refbacks.