Cultural adaptation and pilot psychometric testing of the ‘Person-Centered Primary Care Measure’ (PCPCM) in a Chinese population

Abstract

Introduction: The Person-Centered Primary Care Measure (PCPCM) was developed in 2019 in the USA to holistically assess the vital functions of primary care provided by a doctor or a clinic practice from the patients’ perspective. This study tested the cultural compatibility and psychometric properties of its Chinese translation. Methods: A Chinese translation of the PCPCM was developed by iterative forward-backward translations and its content validity was evaluated through cognitive debriefing interviews with 20 Chinese patients. 300 Chinese adult patients attending a primary care clinic in Hong Kong were then asked to self-administer the Chinese PCPCM, plus the Chinese versions of the Consultation and Relational Empathy (CARE) Measure, the Patient Enablement Instrument (PEI) and the Adult (Short) version of Primary Care Assessment Tool (PCAT). 118 patients were contacted by phone two weeks later to assess re-test reliability of the Chinese PCPCM. Construct validity was examined using item-scale correlations, item fit and dimensionality testing of Rasch analysis. Test-retest reliability was measured by Pearson correlation. Sensitivity was evaluated using known group comparisons. Results: The content validity of the Chinese PCPCM was confirmed with cognitive debriefing. A one-factor construct was confirmed by good item fit and uni-dimensionality on Rasch analysis. Pearson correlation (0.68) between PCPCM scores of first interview and follow-up showed good reproducibility. Cronbach’s alpha >0.8 indicated that the set of items were closely related as a group. Significant correlations (r = 0.42 – 0.58) between PCPCM and CARE, PEI, and PCAT total scores supported convergent validity. The PCPCM scores were higher among patients who had known the doctors longer, were more likely to see the same doctor every visit and self-reported to have “better” than “worse” health. Conclusions: This study confirmed the Chinese translation of the PCPCM to be linguistically equivalent to the original PCPCM and culturally adapted for application amongst Chinese-speakers.