Evaluation of a Patient Experience Tool in Dietetic Practice: Validation and Clinical Usage of the Assessment of Registered Dietitian Care Survey (ARCS)

Publication: Canadian Journal of Dietetic Practice and Research
15 November 2018

Abstract

Purpose: The study aim was to evaluate a patient experience survey, the Assessment of Registered Dietitian Care Survey (ARCS), that is aligned with a nutrition counselling approach (NCA) and evidence-based chronic disease care for use in outpatient registered dietitian (RD) practice.
Methods: Criterion and construct validity were examined using Pearson correlation coefficients and principal components analyses, respectively. Reliability was examined using Pearson correlations and Cronbach’s α. Acceptability was evaluated by survey response rate and readability. Kruskall–Wallis test was used to detect differences between RD scores.
Results: A total of 479 survey packages were returned (46% response rate). Criterion validity indices were high (r = 0.91 and 0.94, P < 0.001) between Patient Assessment of Chronic Illness Care (PACIC) and NCA subscales, respectively, and lower with overall patient satisfaction (r = 0.63–0.65, P < 0.001). Construct validity revealed 2 factors for PACIC and NCA subscales. There was high internal reliability for the PACIC, 5As, and NCA (Cronbach’s α > 0.7) and test–retest reliability showed an adequate consistency over time (r = 0.70, P < 0.05). The tool was able to detect differences in scores between RDs (P < 0.05).
Conclusions: More research is warranted to explore ceiling effects and sensitivity to intervention in similar practice settings. The NCA subscale has acceptable reliability and validity to measure patient experience of RD care.

Résumé

Objectif. L’objectif de cette étude était d’évaluer un sondage sur l’expérience des patients, le sondage sur l’évaluation des soins donnés par les diététistes, qui cadre avec une technique de counseling en nutrition (TCN) et des soins pour maladies chroniques fondés sur des données probantes, aux fins d’une utilisation dans la pratique en clinique externe des diététistes.
Méthodes. Le critère et la validité de construit ont été examinés à l’aide de coefficients de corrélation de Pearson et d’analyses des composantes principales, respectivement. La fidélité a été vérifiée à l’aide de coefficients de corrélation de Pearson et du coefficient alpha de Cronbach. L’acceptabilité a été évaluée à l’aide du taux de réponse au sondage et de sa lisibilité. Un test de Kruskall–Wallis a été utilisé pour détecter les différences entre les scores des diététistes.
Résultats. Au total, 479 trousses de sondage ont été retournées (taux de réponse de 46 %). Les indices de validité du critère étaient élevés (r = 0,91 et 0,94; P < 0,001) entre la sous-échelle de l’évaluation des soins pour maladies chroniques par les patients (ESMCP) et celle de la TCN, respectivement, et plus bas pour la satisfaction globale du patient (r = 0,63–0,65, P < 0,001). La validité de construit a révélé deux facteurs pour les sous-échelles ESMCP et TCN. Il y avait une fidélité interne élevée pour l’ESMCP, les 5 A et la TCN (coefficient alpha de Cronbach > 0,7), et la fidélité de la méthode test-retest a montré une cohérence adéquate au fil du temps (r = 0,70; P < 0,05). L’outil a été en mesure de détecter les différences de score entre les diététistes (P < 0,05).
Conclusions. Davantage de recherches devront être effectuées pour explorer les effets de plafonnement et la sensibilité aux interventions dans des milieux de pratique similaires. La sous-échelle TCN démontre une fidélité et une validité acceptables pour mesurer l’expérience des patients en lien avec les soins prodigués par les diététistes.

Get full access to this article

View all available purchase options and get full access to this article.

Financial support: All funding was from Alberta Health Services; no external sources of funding were received.
Conflict of interest: All authors declare no conflict of interest.

References

1
Desroches S, Lapointe A, Ratte S, Gravel K, Legare F, and Turcotte S. Interventions to enhance adherence to dietary advice for preventing and managing chronic diseases in adults. Cochrane Database Syst Rev. 2013;2:CD008722.
2
Hammond MI, Myers EF, and Trostler N. Nutrition care process and model: an academic and practice odyssey. J Acad Nutr Diet. 2014;114(12):1879–94.
3
American Academy of Nutrition and Dietetics. Nutrition terminology reference manual (eNCPT): dietetics language for nutrition care. Chicago, IL: Academy of Nutrition and Dietetics; 2015.
4
Wagner E, Austin B, Davis C, Hindmarsh M, Schaefer J, and Bonomi A. Improving chronic illness care: translating evidence into action. Health Aff (Millwood). 2001;20(6):64–78.
5
Glasgow RE, Whitesides H, Nelson CC, and King DK. Use of the Patient Assessment of Chronic Illness Care (PACIC) with diabetic patients: relationship to patient characteristics, receipt of care, and self-management. Diab Care. 2005;28(11):2655–61.
6
Coleman K, Austin BT, Brach C, and Wagner EH. Evidence on the chronic care model in the new millennium. Health Aff (Millwood). 2009;28(1):75–85.
7
Fiore MC, Jaén CR, Baker TB. Tobacco use and guidance panel. Treating tobacco use and dependance: 2008 Update. Rockville, MD: US Department of Health and Human Services; 2008. Report No.: NBK63952.
8
Iglesias K, Burnand B, and Peytremann-Bridevaux I. PACIC instrument: disentangling dimensions using published validation models. Int J Qual Health Care. 2014;26(3):250–60.
9
Hung YC, Bauer J, and Isenring E. Patient satisfaction with nutrition services amongst cancer patients treated with autologous stem cell transplantation: a comparison of usual and extended care. J Hum Nutr Diet. 2013;27(Suppl 2):333–38.
10
Moret L, Nguyen JM, Pillet N, Falissard B, Lombrail P, and Gasquet I. Improvement of psychometric properties of a scale measuring inpatient satisfaction with care: a better response rate and a reduction of the ceiling effect. BMC Health Serv Res. 2007;7:197.
11
Vivanti A, Ash S, and Hulcombe J. Validation of a satisfaction survey for rural and urban outpatient dietetic services. J Hum Nutr Diet. 2007; 20:41–49.
12
Glasgow RE, Wagner EH, Schaefer J, Mahoney LD, Reid RJ, and Greene SM. Development and validation of the Patient Assessment of Chronic Illness Care (PACIC). Med Care. 2005;43(5):436–44.
13
Vrijhoef HJ, Berbee R, Wagner EH, and Steuten LM. Quality of integrated chronic care measured by patient survey: identification, selection and application of most appropriate instruments. Health Expect. 2009;12(4):417–29.
14
Health Quality Council of Alberta. Satisfaction and experience with healthcare services: a survey of Albertans 2012. Calgary, AB: Health Quality Council of Alberta; 2012.
15
Kaiser HF. A second generation little jiffy. Psychometrika. 1970;35(4):401–15.
16
Kaiser HF. An index of factorial simplicity. Psychometrika. 1974;39(1):31–36.
17
Bartlett MS. A note on the multiplying factors for various chi square approximations. J. Royal Stat Soc. 1954;16(Series B):296–98.
18
Pallant, J. SPSS survival manual. 5th ed. Maidenhead, Berkshire, England: Open University Press; 2013.
19
Hollander, M, Wolfe, D. Nonparametric statistical methods. 2nd ed. New York, NY: John Wiley & Sons, Inc.; 1999.
20
Cohen J. A power primer. Psychol Bull. 1992;112(1):155–59.
21
Streiner, D, Norman, G. Health measurement scales. 3rd ed. Oxford, NY: Oxford University Press; 2003.
22
Nunnally, JO. Psychometric theory. New York, NY: McGraw-Hill; 1978.
23
McLaughlin GH. SMOG grading: a new readability formula. J Read. 1969;12(8):639–46.
24
Cramm JM and Nieboer AP. Factorial validation of the Patient Assessment of Chronic Illness Care (PACIC) and PACIC short version (PACIC-S) among cardiovascular disease patients in the Netherlands. Health Qual Life Outcomes. 2012;10:104.
25
Fan J, McCoy RG, Ziegenfuss JY, Smith SA, Borah BJ, Deming JR, et al. Evaluating the structure of the Patient Assessment of Chronic Illness Care (PACIC) survey from the patient’s perspective. Ann Behav Med. 2015;49(1):104–11.
26
Szecsenyi J, Rosemann T, Joos S, Peters-Klimm F, and Miksch A. German diabetes disease management programs are appropriate for restructuring care according to the chronic care model: an evaluation with the Patient Assessment of Chronic Illness Care instrument. Diab Care. 2008;31(6):1150–54.
27
Taylor LM, Moriartey S, Stadnyk J, and Basualdo-Hammond C. Assessment of registered dietitians beliefs and practices for a nutrition counselling approach. Can J Diet Pract Res. 2016;77(3);140–47.
28
McIntosh C. Examining the factorial validity of selected modules from the Canadian survey of experiences with primary health care. Ottawa, ON: Statistics Canada; 2008 [cited 2018 Jul 1] Available from: http://www.statcan.gc.ca/pub/82-622-x/82-622-x2008001-eng.htm.
29
Doak C, Doak L. Teaching patients with low literacy skills. 2nd ed. Philadelphia, PA: JB Lippincott Company; 1996.

Supplementary Material

File (cjdpr-2018-036suppla.docx)

Information & Authors

Information

Published In

cover image Canadian Journal of Dietetic Practice and Research
Canadian Journal of Dietetic Practice and Research
Volume 80Number 2June 2019
Pages: 48 - 54

History

Version of record online: 15 November 2018

Authors

Affiliations

Allison Fielding BSc, RD
Nutrition Services, Alberta Health Services, Edmonton, AB
Lorian M. Taylor PhD, RD
Nutrition Services, Alberta Health Services, Edmonton, AB
Stephanie Moriartey PhD, RD
Nutrition Services, Alberta Health Services, Edmonton, AB
Janet Stadynk BSc, RD
Nutrition Services, Alberta Health Services, Edmonton, AB

Metrics & Citations

Metrics

Other Metrics

Citations

Cite As

Export Citations

If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.

There are no citations for this item

View Options

Login options

Check if you access through your login credentials or your institution to get full access on this article.

Subscribe

Click on the button below to subscribe to Canadian Journal of Dietetic Practice and Research

Purchase options

Purchase this article to get full access to it.

Restore your content access

Enter your email address to restore your content access:

Note: This functionality works only for purchases done as a guest. If you already have an account, log in to access the content to which you are entitled.

View options

PDF

View PDF

Full Text

View Full Text

Media

Media

Other

Tables

Share Options

Share

Share the article link

Share on social media