Patients Assessment of Chronic Illness Care

We would like to highlight a specific aspect of the paper by Vrijhoef et al.,1 in which they compare patient questionnaires for integrated chronic care and test the Patients Assessment of Chronic Illness Care (PACIC) questionnaire as the most appropriate instrument. Our comment is based on our previously published study on the PACIC questionnaire in the same country.2 We found that a substantial number of chronically ill patients did not understand the questions or felt that these were not relevant to them. We tried a direct translation of the English PACIC questionnaire into Dutch, like Vrijhoef et al., but found in pilot interviews that the language was too difficult. We radically rephrased the items into short, active sentences, to make them more accessible for people with low literacy levels. Nevertheless, a substantial proportion of our respondents did not complete the PACIC questionnaire, although they completed other parts of the questionnaire (including the EUROPEP questionnaire). Unfortunately, information on item-response is lacking in the paper by Vrijhoef et al., except that 7 of the 89 respondents were excluded because of missing values. Given the non-representative sampling procedure they used (convenience sampling in a special setting for delivery of chronic care), we would argue that further research is needed on their version of the Dutch PACIC questionnaire, focused on patients with low literacy levels

Health care · Health literacy · Literacy · Pedagogy · Chronic Disease Management Strategies · Computer Science · Diabetes Management and Education · Medicine · Nursing · Patient Satisfaction in Healthcare · Psychology

• Development and psychometric evaluation of a measure to evaluate the quality of integrated care

  Open Access•Ronald J Uittenbroek, Sijmen A Reijneveld et al.•Health Expectations•2016

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• Quality of integrated chronic care measured by patient survey

  Open Access•Hubertus J M Vrijhoef, Rieneke Berbee et al.•Health Expectations•2009

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