Evaluation of the psychometric performance of the Spanish and Catalan versions of the patient reported experiences and Outcomes of Safety in Primary Care (PREOS-PC)-Compact questionnaire.

European Journal of General Practice 2024, VOL. 30, NO. 1, 2296573 https://doi.org/10.1080/13814788.2023.2296573 RESEARCH ARTICLE Evaluation of the psychometric performance of the Spanish and Catalan versions of the patient reported experiences and Outcomes of Safety in Primary Care (PREOS-PC)-Compact questionnaire Maria A. Fiol-deRoquea,b,c , José M. Valderasd,e , Jorge Arias de la Torref,g,h , Maria J. Serrano-Ripolla,b,c , Montserrat Gens-Barberài,j , Encarna Sánchez-Freirek , Francisco M. Martín-Lujánl,m , Antonio Olry de Labryf,n and Ignacio Ricci-Cabelloa,b,f Research Group in Primary Care and Promotion – Balearic Islands Community (GRAPP-caIB), Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain; bPrimary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma, Spain; cPrevention and Health Promotion Research Network (redIAPP)/Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, Spain; dCentre for Research in Health Systems Performance, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; eDepartment of Family Medicine, National University Health System, Singapore, Singapore; fInstitute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK; gCIBER Biomedical Research Center in Epidemiology and Public Health (CIBERESP), Health Institute Carlos III (ISCIII), Madrid, Spain; hInstitute of Biomedicine, University of Leon, Leon, Spain; iQuality and Patient Safety Central Functional Unit, Gerència d‘Atenció Primària Camp de Tarragona, Catalan Institute of Health (ICS), Tarragona, Spain; j Research Group in Quality and Patient Safety, Institut Universitari d’Investigació en l’Atenció Primària-IDIAP Jordi Gol, Catalan Institute of Health (ICS), Tarragona, Spain; kQuality and Patient Safety Unit, Gerència d‘Atenció Primària Catalunya Central, Catalan Institute of Health (ICS), Barcelona, Spain; lPrimary Healthcare Research Support Unit-Camp de Tarragona, Institut Universitari d’Investigació en l’Atenció Primària-IDIAP Jordi Gol, Catalan Institute of Health (ICS), Tarragona, Spain; mDepartment of Medicine, Faculty of Medicine and Health Sciences, Universitat Rovira i Virgili (URV), Reus, Spain; nResearch Group in Health and Gender, Andalusian School of Public Health, Granada, Spain a ABSTRACT Background: Patients provide a unique, irreplaceable, and essential perspective in evaluating patient safety. The suite of Patient Reported Experiences and Outcomes of Safety in Primary Care (PREOS-PC) tools are a notable exception to the scarcity of patient-reported patient safety measures. Full evaluation of their performance has only been attempted for the English version, thereby limiting its international applicability. Objectives: To assess the psychometric performance of the Spanish and Catalan versions of the PREOS-PC-Compact. Methods: Cross-sectional validation study. We used Classical Test Theory methods to examine scale score distribution, internal consistency, and construct validity; and Item Response Theory (IRT) methods to further explore construct validity. Results: 3287 patients completed the Spanish version, and 1007 the Catalan version. Similar results were obtained for both versions. Confirmatory Factor Analysis supported a single construct for each scale. The correlations between PREOS-PC-Compact scales and known group analysis suggested adequate construct validity (inconclusive for known groups at the provider level). All four multi-item scales demonstrated adequate internal consistency reliability (α > 0.7), which was only confirmed for test-retest reliability for ‘Practice activation.’ A sample between 60–90 patients per practice was estimated sufficient to produce scores with reliability > 0.7 for all scales except for harm scales. IRT models showed disordered thresholds for ‘Practice activation’ and ‘Harm burden’ but showed excellent fit after reducing the response categories. Conclusion: The Spanish and Catalan versions of the PREOS-PC-Compact are broadly valid and reliable tools to measure patient safety in Spanish primary care centres; confirmation of lower-thanexpected test-rest reliability merits further examination . ARTICLE HISTORY Received 7 March 2023 Revised 23 November 2023 Accepted 4 December 2023 KEYWORDS Health care evaluation mechanisms; observational study; patient safety; patient reported outcomes; primary health care CONTACT Maria A. Fiol-deRoque Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Carrer de l’Escola Graduada, 3, Palma 07002, Spain; Health Research Institute of the Balearic Islands (IdISBa), Palma 07010, Spain Supplemental data for this article can be accessed online at https://doi.org/10.1080/13814788.2023.2296573. © 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent. 2 M. A. FIOL-DEROQUE ET AL. Introduction The Organisation for Economic Co-operation and Development (OECD) reports that approximately 20%– 25% of individuals receiving primary and ambulatory care suffer harm, resulting in a direct cost of about 2.5% of total health expenditure due to additional tests, treatments, and healthcare [1]. In Spain, around 3 million adverse events occur in the Primary Care Centres (PCC) [2], resulting in costs of up to 1000 million Euros per year [3]. Consequently, patient safety (defined as ‘the prevention of errors and adverse effects to patients associated with healthcare’) has become a significant focus for primary care systems worldwide [4]. The lack of appropriate measurement tools impedes efforts to enhance patient safety [5]. Available tools rely on healthcare providers’ information, such as safety culture questionnaires or voluntary reporting of safety events by health professionals, while patient-reported tools are scarce. However, over the last decade, patient participation in incident prevention and harm reduction has gained momentum [6]. Patients, as care recipients, often spot different safety incidents and outcomes than staff, being motivated to report errors [7]. This engagement yields positive results in preventing adverse events and increasing awareness of safety risks [6,8–10]. Indeed, patient-reported data drives successful innovative interventions for safer health systems [11–13]. The Patient-Reported Experiences and Outcomes of Safety in Primary Care (PREOS-PC) questionnaire is an innovative patient-centred tool used to measure patient safety in primary care s (...truncated)