Evaluation of a culturally adapted German version of the Patient Assessment of Chronic Illness Care (PACIC 5A) questionnaire in a sample of osteoarthritis patients

J Eval Clin Pract. 2007 Oct;13(5):806-13. doi: 10.1111/j.1365-2753.2007.00786.x.


Objective: The chronic care model and the 5A approach have achieved widespread acceptance and reflect the core elements of patient-centred care in chronic diseases, including arthritis. Appropriate assessment tools are indispensable to assess whether provided care is in alignment with these evidence-based conceptual frameworks of care. The aim of this study was to examine the validity of a translated and culturally adapted version of the Patient Assessment of Chronic Illness Care (PACIC 5A) questionnaire among osteoarthritis (OA) patients.

Methods: Of 300 administered questionnaires, 236 (78.6%) were returned. Established statistical approaches were used in order to assess psychometric properties. Test-retest reliability was tested in 75 randomly selected patients who received the questionnaire a second time after 2 weeks. The EUROPEP questionnaire was used in order to address external validity.

Results: Scale internal consistency was confirmed with values ranging from 0.52 to 0.97 for Pearson's r. Internal consistency reliability was satisfying: Cronbach's alpha was 0.78 or higher for all scales. Test-retest reliability (intraclass correlation coefficient) exceeded 0.77. Correlations with the EUROPEP, which is not organized according to a conceptual approach to care, were only strong in corresponding scales.

Conclusions: The PACIC 5A is a reliable and valid instrument to assess the congruency of care to the chronic care model of OA patients. Its use is encouraged in quality improvement projects but also in further research.

MeSH terms

  • Aged
  • Chronic Disease
  • Cultural Characteristics*
  • Female
  • Germany
  • Humans
  • Male
  • Middle Aged
  • Osteoarthritis / therapy*
  • Patient Care Management / organization & administration*
  • Psychometrics
  • Reproducibility of Results
  • Surveys and Questionnaires*
  • Treatment Outcome