The Chinese version of patient experience with treatment and self-management (PETS vs. 2.0): translation and validation in patients with multimorbidity in primary care in Hong Kong.
Multimorbidity
PETS
Primary care
Treatment burden
Validation
Journal
Journal of patient-reported outcomes
ISSN: 2509-8020
Titre abrégé: J Patient Rep Outcomes
Pays: Germany
ID NLM: 101722688
Informations de publication
Date de publication:
02 Aug 2024
02 Aug 2024
Historique:
received:
23
04
2024
accepted:
14
07
2024
medline:
2
8
2024
pubmed:
2
8
2024
entrez:
2
8
2024
Statut:
epublish
Résumé
Validated and comprehensive tools to measure treatment burden are needed for healthcare professionals to understand the treatment burden of patients in China. The study aimed to translate and validate the Chinese version of Patient Experience with Treatment and Self-management (PETS vs. 2.0) in patients with multimorbidity in primary care. The translation process of the 60-item PETS vs. 2.0 followed the Functional Assessment of Chronic Illness Therapy (FACIT) Translation, Formatting, and Testing Guidelines. Computer-assisted assessments were conducted in adult primary care patients with multimorbidity from three general out-patient clinics in Hong Kong. A sample of 502 patients completed the assessments from July to December 2023. Internal reliability was examined using Cronbach's alphas for each domain of the PETS vs. 2.0. Concurrent validity was assessed through the correlations between different domains of PETS vs. 2.0 with established measures including quality of life, frailty, and depression. Confirmatory Factor Analysis (CFA) with maximum likelihood method was carried out to assess the construct validity. The mean age of participants was 64.9 years old and 56.2% were female. Internal consistency reliability was acceptable (alpha ≥ 0.70) for most domains. Higher scores of PETS domains were significantly correlated with worse quality of life, higher level of frailty, and more depressive symptoms (p < 0.05). In CFA, after setting the covariances on the error variances, the adjusted model revealed an acceptable model fit (χ The Chinese version of PETS vs. 2.0 is a reliable and valid tool for assessing the perceived treatment burden in patients with multimorbidity in primary care. All domains and items in the original questionnaires were retained.
Sections du résumé
BACKGROUND
BACKGROUND
Validated and comprehensive tools to measure treatment burden are needed for healthcare professionals to understand the treatment burden of patients in China. The study aimed to translate and validate the Chinese version of Patient Experience with Treatment and Self-management (PETS vs. 2.0) in patients with multimorbidity in primary care.
METHODOLOGY
METHODS
The translation process of the 60-item PETS vs. 2.0 followed the Functional Assessment of Chronic Illness Therapy (FACIT) Translation, Formatting, and Testing Guidelines. Computer-assisted assessments were conducted in adult primary care patients with multimorbidity from three general out-patient clinics in Hong Kong. A sample of 502 patients completed the assessments from July to December 2023. Internal reliability was examined using Cronbach's alphas for each domain of the PETS vs. 2.0. Concurrent validity was assessed through the correlations between different domains of PETS vs. 2.0 with established measures including quality of life, frailty, and depression. Confirmatory Factor Analysis (CFA) with maximum likelihood method was carried out to assess the construct validity.
RESULTS
RESULTS
The mean age of participants was 64.9 years old and 56.2% were female. Internal consistency reliability was acceptable (alpha ≥ 0.70) for most domains. Higher scores of PETS domains were significantly correlated with worse quality of life, higher level of frailty, and more depressive symptoms (p < 0.05). In CFA, after setting the covariances on the error variances, the adjusted model revealed an acceptable model fit (χ
CONCLUSIONS
CONCLUSIONS
The Chinese version of PETS vs. 2.0 is a reliable and valid tool for assessing the perceived treatment burden in patients with multimorbidity in primary care. All domains and items in the original questionnaires were retained.
Identifiants
pubmed: 39093529
doi: 10.1186/s41687-024-00765-1
pii: 10.1186/s41687-024-00765-1
doi:
Types de publication
Journal Article
Validation Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
82Informations de copyright
© 2024. The Author(s).
Références
Van Den Akker M, Buntinx F, Knottnerus JA (1996) Comorbidity or multimorbidity: what’s in a name? A review of literature. Eur J Gen Pract 2(2):65–70
doi: 10.3109/13814789609162146
Violan C, Foguet-Boreu Q, Flores-Mateo G, Salisbury C, Blom J, Freitag M et al (2014) Prevalence, determinants and patterns of multimorbidity in primary care: a systematic review of observational studies. PLoS One 9(7):e102149. https://doi.org/10.1371/journal.pone.0102149
doi: 10.1371/journal.pone.0102149
pubmed: 25048354
pmcid: 4105594
Chu T, Lau P, Cheng RS, Chan M, Liang J (2018) A study on the prevalence of multi-morbidities of diseases and utilisation of public healthcare services in the New Territories West area of Hong Kong. Hong Kong Pract 40(2):43–50
Hua J, Zhaoxin W, Aizhen G, Hanzhi Z, Wei L, Yuqin Z et al (2022) Patterns of multimorbidity in community health centres in Shanghai, China: a retrospective, cross-sectional study based on outpatient data from 2014 to 2018. BMJ Open 12(10):e048727. https://doi.org/10.1136/bmjopen-2021-048727
doi: 10.1136/bmjopen-2021-048727
pubmed: 36198446
pmcid: 9535180
Chin WY, Choi EPH, Wan EYF, Lam CLK (2016) Health-related quality of life mediates associations between multi-morbidity and depressive symptoms in Chinese primary care patients. Fam Pract 33(1):61–68
doi: 10.1093/fampra/cmv090
pubmed: 26567547
Chen YH, Karimi M, Rutten-van Mölken M (2020) The disease burden of multimorbidity and its interaction with educational level. PLoS One 15(12):e0243275. PMID: 33270760. https://doi.org/10.1371/journal.pone.0243275
doi: 10.1371/journal.pone.0243275
pubmed: 33270760
pmcid: 7714131
Bell C, Appel CW, Frølich A, Prior A, Vedsted P (2022) Improving health care for patients with multimorbidity: a mixed-methods study to explore the feasibility and process of aligning scheduled outpatient appointments through collaboration between medical specialties. Int J Integr Care 22(1):17. PMID: 35340347. https://doi.org/10.5334/ijic.6013 .
doi: 10.5334/ijic.6013
pubmed: 35340347
pmcid: 8896239
Dou L, Huang J, Duncan P, Guo L (2020) Translation, cultural adaptation and validation of the Chinese multimorbidity treatment burden questionnaire (C-MTBQ): a study of older hospital patients. Health Qual Life Outcomes 18(1):194. https://doi.org/10.1186/s12955-020-01395-z
doi: 10.1186/s12955-020-01395-z
pubmed: 32571343
pmcid: 7310246
Eton DT, Yost KJ, Lai J-S, Ridgeway JL, Egginton JS, Rosedahl JK et al (2017) Development and validation of the patient experience with treatment and self-management (PETS): a patient-reported measure of treatment burden. Qual Life Res 26(2):489–503. https://doi.org/10.1007/s11136-016-1397-0
doi: 10.1007/s11136-016-1397-0
pubmed: 27566732
Hounkpatin HO, Roderick P, Harris S, Morris JE, Smith D, Walsh B et al (2022) Change in treatment burden among people with multimorbidity: a follow-up survey. Br J Gen Pract 72(724):e816–e824. PMID: 36302680. https://doi.org/10.3399/bjgp.2022.0103
doi: 10.3399/bjgp.2022.0103
pubmed: 36302680
pmcid: 9466958
Aramrat C, Choksomngam Y, Jiraporncharoen W, Wiwatkunupakarn N, Pinyopornpanish K, Mallinson PAC et al (2022) Advancing multimorbidity management in primary care: a narrative review. Prim Health Care Res Dev 23:e36. PMID: 35775363. https://doi.org/10.1017/s1463423622000238
doi: 10.1017/s1463423622000238
pubmed: 35775363
pmcid: 9309754
Hu XJ, Wang HHX, Li YT, Wu XY, Wang Y, Chen JH et al (2022) Healthcare needs, experiences and treatment burden in primary care patients with multimorbidity: an evaluation of process of care from patients’ perspectives. Health Expect 25(1):203–213. PMID: 34585465. https://doi.org/10.1111/hex.13363
doi: 10.1111/hex.13363
pubmed: 34585465
Sheehan OC, Leff B, Ritchie CS, Garrigues SK, Li L, Saliba D et al (2019) A systematic literature review of the assessment of treatment burden experienced by patients and their caregivers. BMC Geriatr 19(1):262. https://doi.org/10.1186/s12877-019-1222-z
doi: 10.1186/s12877-019-1222-z
pubmed: 31604424
pmcid: 6788093
Sasseville M, Chouinard MC, Fortin M (2021) Understanding patient outcomes to develop a multimorbidity adapted patient-reported outcomes measure: a qualitative description of patient and provider perspectives. Health Qual Life Outcomes 19(1):43. PMID: 33541383. https://doi.org/10.1186/s12955-021-01689-w
doi: 10.1186/s12955-021-01689-w
pubmed: 33541383
pmcid: 7863435
Duguay C, Gallagher F, Fortin M (2014) The experience of adults with multimorbidity: a qualitative study. J Comorb 4:11–21. PMID: 29090149. https://doi.org/10.15256/joc.2014.4.31
doi: 10.15256/joc.2014.4.31
pubmed: 29090149
pmcid: 5556408
Chin WY, Wong CKH, Ng CCW, Choi EPH, Lam CLK (2019) Cultural adaptation and psychometric properties of the Chinese burden of treatment questionnaire (C-TBQ) in primary care patients with multi-morbidity. Fam Pract 36(5):657–665
doi: 10.1093/fampra/cmz008
pubmed: 30820558
Sav A, King MA, Whitty JA, Kendall E, McMillan SS, Kelly F et al (2015) Burden of treatment for chronic illness: a concept analysis and review of the literature. Health Expect 18(3):312–324
doi: 10.1111/hex.12046
pubmed: 23363080
Eton DT, Ridgeway JL, Egginton JS, Tiedje K, Linzer M, Boehm DH et al (2015) Finalizing a measurement framework for the burden of treatment in complex patients with chronic conditions. Patient Relat Outcome Meas 6(null):117–126. https://doi.org/10.2147/PROM.S78955
doi: 10.2147/PROM.S78955
pubmed: 25848328
pmcid: 4383147
Eton DT, Lee MK, St. Sauver JL, Anderson RT (2020) Known-groups validity and responsiveness to change of the patient experience with treatment and self-management (PETS vs. 2.0): a patient-reported measure of treatment burden. Qual Life Res 29(11):3143–3154. https://doi.org/10.1007/s11136-020-02546-x
doi: 10.1007/s11136-020-02546-x
pubmed: 32524346
pmcid: 8012109
Wood K, Sardar A, Eton DT, Mair FS, Kidd L, Quinn TJ et al (2023) Adaptation and content validation of a patient-reported measure of treatment burden for use in stroke survivors: the patient experience with treatment and self-management in stroke (PETS-stroke) measure. Disabil Rehabil 1–10. https://doi.org/10.1080/09638288.2023.2241360
Husebø AML, Morken IM, Eriksen KS, Nordfonn OK (2018) The patient experience with treatment and self-management (PETS) questionnaire: translation and cultural adaption of the Norwegian version. BMC Med Res Method 18:1–12
doi: 10.1186/s12874-018-0612-9
Koros H, Nolte E, Kamano J, Mugo R, Murphy A, Naanyu V et al (2023) Understanding the treatment burden of people with chronic conditions in Kenya: a cross-sectional analysis using the patient experience with treatment and self-management (PETS) questionnaire. PLOS Glob Public Health 3(1):e0001407
doi: 10.1371/journal.pgph.0001407
pubmed: 36962994
pmcid: 10021888
Rogers E, Manser S, Linzer M, Arriaza S (2023) Translation and validation of a Spanish version of the patient experience with treatment and self-management (PETS) measure. Ann Fam Med 21(Supplement 3):5414
Eton DT, Anderson RT, Cohn WF, Kennedy EM, St. Sauver JL, Bucknell BJ et al (2019) Risk factors for poor health-related quality of life in cancer survivors with multiple chronic conditions: exploring the role of treatment burden as a mediator. Patient Relat Outcome Meas 10:89–99
Song M-K, Paul S, Plantinga L, Henry C, Turberville-Trujillo L (2019) Social networks of self-care and perceived treatment burden among patients on in-center hemodialysis. Kidney Med 1(3):97–103
doi: 10.1016/j.xkme.2019.04.001
pubmed: 32734190
pmcid: 7380407
Nordfonn OK, Morken IM, Bru LE, Larsen AI, Husebø AML (2021) Burden of treatment in patients with chronic heart failure–a cross-sectional study. Heart Lung 50(3):369–374
doi: 10.1016/j.hrtlng.2021.02.003
pubmed: 33618147
Husebø AM, Dalen I, Richardson A, Bru E, Søreide JA (2021) Factors influencing treatment burden in colorectal cancer patients undergoing curative surgery: a cross-sectional study. Eur J Cancer Care 30(5):e13437
doi: 10.1111/ecc.13437
Jin XW, Slomka J, Blixen CE (2002) Cultural and clinical issues in the care of Asian patients. Cleve Clin J Med 69(1):50–61
doi: 10.3949/ccjm.69.1.50
pubmed: 11811720
Li X, Lu J, Hu S, Cheng K, De Maeseneer J, Meng Q et al (2017) The primary health-care system in China. Lancet 390(10112):2584–2594
doi: 10.1016/S0140-6736(17)33109-4
pubmed: 29231837
Lin K, Yao M, Andrew L, Li R, Chen Y, Oosthuizen J et al (2024) Exploring treatment burden in people with type 2 diabetes mellitus: a thematic analysis in china’s primary care settings. BMC Prim Care 25(1):88. https://doi.org/10.1186/s12875-024-02301-y
doi: 10.1186/s12875-024-02301-y
pubmed: 38491369
pmcid: 10941610
Wong SYS, Zhang D, Sit RWS, Yip BHK, Chung RY-N, Wong CKM et al (2020) Impact of COVID-19 on loneliness, mental health, and health service utilisation: a prospective cohort study of older adults with multimorbidity in primary care. Br J Gen Pract 70(700):e817–e824
doi: 10.3399/bjgp20X713021
pubmed: 32988955
pmcid: 7523921
Zhang D, Sit RWS, Wong C, Zou D, Mercer SW, Johnston MC et al (2020) Cohort profile: the prospective study on Chinese elderly with multimorbidity in primary care in Hong Kong. BMJ Open 10(2):e027279
doi: 10.1136/bmjopen-2018-027279
pubmed: 32086349
pmcid: 7045043
Iris SSH, Amaya A-L, Ashley A, Jim D, Kamlesh K, Umesh TK et al (2022) Measuring multimorbidity in research: delphi consensus study. BMJ Med 1(1):e000247. https://doi.org/10.1136/bmjmed-2022-000247
doi: 10.1136/bmjmed-2022-000247
Luo N, Chew LH, Fong KY, Koh DR, Ng SC, Yoon KH et al (2003) Validity and reliability of the EQ-5D self-report questionnaire in Chinese-speaking patients with rheumatic diseases in Singapore. Ann-Acad Med Singap 32(5):685–690
doi: 10.47102/annals-acadmedsg.V32N5p685
pubmed: 14626802
Church S, Rogers E, Rockwood K, Theou O (2020) A scoping review of the clinical frailty scale. BMC Geriatr 20:1–18
doi: 10.1186/s12877-020-01801-7
Chou Y-C, Tsou H-H, Chan D-CD, Wen C-J, Lu F-P, Lin K-P et al (2022) Validation of clinical frailty scale in Chinese translation. BMC Geriatr 22(1):604
doi: 10.1186/s12877-022-03287-x
pubmed: 35858829
pmcid: 9298166
Wang W, Bian Q, Zhao Y, Li X, Wang W, Du J et al (2014) Reliability and validity of the Chinese version of the patient health questionnaire (PHQ-9) in the general population. Gen Hosp Psychiatry 36(5):539–544. https://doi.org/10.1016/j.genhosppsych.2014.05.021
doi: 10.1016/j.genhosppsych.2014.05.021
pubmed: 25023953
Eremenco SL, Cella D, Arnold BJ (2005) A comprehensive method for the translation and cross-cultural validation of health status questionnaires. Eval Health Professions 28(2):212–232
doi: 10.1177/0163278705275342
Bryman A, Cramer D (1997) Quantitative data analysis with SPSS for Windows: a guide for social scientists. Routledge, New York. ISBN: 0415147204
Nunnally J, Bernstein IH (1994) Psychometric theory (3rd Ed.). New York: Allyn and Bacon
Comrey AL, Lee HB (2013) A first course in factor analysis. Psychology Press, New York. ISBN: 1317844076
doi: 10.4324/9781315827506
Cohen J (1988) Statistical power analysis for the behavioral sciences, 2nd edn. Erlbaum, Hillsdale, NJ
Blake DD, Weathers FW, Nagy LM, Kaloupek DG, Gusman FD, Charney DS et al (1995) The development of a clinician-administered PTSD scale. J Trauma Stress 8(1):75–90. https://doi.org/10.1007/BF02105408
doi: 10.1007/BF02105408
pubmed: 7712061
Lee MK, St Sauver JL, Anderson RT, Linzer M, Eton DT (2021) Confirmatory factor analyses and differential item functioning of the patient experience with treatment and self-management (PETS vs. 2.0): a measure of treatment burden. Patient Relat Outcome Meas 11:249–263
Hu L, Bentler PM (1998) Fit indices in covariance structure analysis: sensitivity to underparameterized model misspecification. Psychol Methods 3:424–453
doi: 10.1037/1082-989X.3.4.424
Hu L, Bentler P (1999) Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equat Model 6(1):1–55
doi: 10.1080/10705519909540118
Elsborg P, Melby PS, Kurtzhals M, Tremblay MS, Nielsen G, Bentsen P (2021) Translation and validation of the Canadian assessment of physical literacy-2 in a Danish sample. BMC Public Health 21(1):2236. https://doi.org/10.1186/s12889-021-12301-7
doi: 10.1186/s12889-021-12301-7
pubmed: 34886833
pmcid: 8656017
Brown TA (2015) Confirmatory factor analysis for applied research. Guilford Publications, New York. ISBN: 146251779X
Arifin WN, Bahri Yusoff MS, Naing NN (2012) Confirmatory factor analysis (CFA) of USM emotional quotient inventory (USMEQ-i) among medical degree program applicants in Universiti Sains Malaysia (USM). Educ Med J 4(2):e26–44
Gebreyohannes EA, Gebresillassie BM, Mulugeta F, Dessu E, Abebe TB (2023) Treatment burden and health-related quality of life of patients with multimorbidity: a cross-sectional study. Qual Life Res 32(11):3269–3277. PMID: 37405663. https://doi.org/10.1007/s11136-023-03473-3
doi: 10.1007/s11136-023-03473-3
pubmed: 37405663
pmcid: 10522511
Eton DT, Linzer M, Boehm DH, Vanderboom CE, Rogers EA, Frost MH et al (2020) Deriving and validating a brief measure of treatment burden to assess person-centered healthcare quality in primary care: a multi-method study. BMC Fam Pract 21(1):221. https://doi.org/10.1186/s12875-020-01291-x
doi: 10.1186/s12875-020-01291-x
pubmed: 33115421
pmcid: 7594460
Sporinova B, Manns B, Tonelli M, Hemmelgarn B, MacMaster F, Mitchell N et al (2019) Association of mental health disorders with health care utilization and costs among adults with chronic disease. JAMA Network Open 2(8):e199910–e. https://doi.org/10.1001/jamanetworkopen.2019.9910
doi: 10.1001/jamanetworkopen.2019.9910
pubmed: 31441939
pmcid: 6714022