Development of a patient-reported measure of the interpersonal quality of family planning care

Abstract

Objective: The objective was to describe the development and assess evidence of the validity of a patient-reported scale measuring the interpersonal quality of contraceptive counseling.

Study design: We performed initial item selection based on qualitative work regarding patient preferences for contraceptive counseling and a review of patient-reported measures of communication. We then administered these items as part of a cohort study of women receiving contraceptive counseling, along with items measuring patient satisfaction with counseling and method choice, and coded audio recordings of the contraceptive counseling visits for patient-centered communication. We determined the final scale based on interitem correlations and exploratory factor analysis. Predictive validity of the scale has been demonstrated previously. We assessed content, construct, convergent and discriminant validity by investigating associations between the final scale and the satisfaction and audio-recording-derived measures using mixed effects logistic regression.

Results: The items were administered to 346 women between 2009 and 2012 in the San Francisco area. We selected an 11-item, 1-factor Interpersonal Quality of Family Planning (IQFP) scale, with a Cronbach's alpha of 0.95. This scale showed positive associations with measures of satisfaction with counseling and with the chosen method. IQFP was also associated with provider communication practices, including eliciting the patient perspective and demonstrating empathy.

Conclusions and implications: The IQFP scale demonstrates construct, convergent, discriminant and predictive validity for measuring the interpersonal quality of contraceptive counseling. It shows promise as a measure that can be used in research and quality improvement efforts to ensure that patients' experiences and preferences are prioritized in family planning care.

Keywords: Communication; Contraceptive counseling; Instrument development; Measurement; Patient-centered care; Quality.