Scale development to measure the patient perception of patient-centered care of dentists in primary care settings of Thailand: a measurement invariance test

Abstract

Abstract Background Patient-centered care is essential for providing quality services thoroughly from the primary care level, but it is unclear and lacks measurement. This study aimed to develop a reliable and valid instrument to measure patient perception of patient-centered care of primary dental care in Thailand and test the measurement invariance between the large and small community hospitals.Methods The initial set of 45 items for the Patient Perception of Patient-Centered Care of Dentist Scale (PPCCDS) was developed using a mixed-method approach, which included a literature review, content validity test, cognitive interviews, and a pre-test. A multistage sampling strategy was used to recruit dental patients or parents/caregivers from community hospitals across Thailand. Validity was examined through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Reliability was assessed using Cronbach's alpha coefficient and intraclass correlation coefficient. Furthermore, a multi-group analysis was conducted to compare the responses of patients from large and small community hospitals.Results 336 and 1167 samples were randomized for EFA and CFA, respectively. The final PPCCDS consists of 7 factors with satisfactory reliability and validity and composed of 42 items: dentist-patient relationship, disease-illness, integrated care, communication, shared information and decision-making, holistic and empathy and anxiety management. The CFA showed the model fit was consistent with the entire sample. The metric invariance analysis showed that the factor loadings were invariant across patient groups. Overall Cronbach's alpha coefficient and intraclass correlation coefficient were satisfactory.Conclusions The newly developed PPCCDS is composed of seven domains with 42 items with good reliability and validity, and it indicated the measurement invariance across patients in large and small community hospitals.