P263. Elaboration and validation of a questionnaire to evaluate patients satisfaction with healhtcare services: CACHE questionnaire
F. Casellas1, D. Ginard2, A. Torrejón Herrera1, I. Vera3
1Hospital Universitari Vall d'Hebron, Ciberehd, Barcelona, Spain; 2Hospital Universitari Son Espases, Palma de Mallorca, Spain; 3Hospital Universitario Puerta de Hierro, Majadahonda, Spain
Background: The quality of life of patients with inflammatory bowel disease (IBD) is often considered in the centres in which they are treated. However, there is no tool to evaluate satisfaction of these patients with healthcare services. The aim of this study was to design and validate a questionnaire focused on evaluation of the IBD patient's satisfaction with healthcare services.
Methods: The CACHE questionnaire was developed in three steps: (i) literature review identifying a list of 37 items, (ii) focus group meeting with 5 experts to define the items and structure of the questionnaire, (iii) edition of the questionnaire and administration to a sample of 20 patients to evaluate their understanding of the items. The final version of the questionnaire (31 items) was used in the validation. An epidemiological, prospective, naturalistic, multicentre study (35 gastroenterologists) of adult patients with Crohn's (CD) or Ulcerative Colitis (UC) was performed. All patients were controlled in hospital, had a disease evolution ≥1 year and were in treatment. Each patient had 3 visits (baseline, 2 months and 46 months).
Results: The study included 327 patients (171 CD and 156 UC). Slightly more patients were men (53%). The mean (SD) age was 41 (13) years. Ninety one percent of patients answered all items on the questionnaire at the baseline visit. CACHE questionnaire consists in 31 items distributed in six dimensions (healthcare staff attention, doctor attention, facilities, information, accessibility to the centre and received support) which explained the 56% of the information variability. Results are scored in a scale from 0 (minimum satisfaction) to 100 (maximum satisfaction). Four percent of patients showed maximum satisfaction (100), and none reported no satisfaction. The mean overall score was 82 (11). The overall score did not correlate with clinical variables, but correlated with the waiting time in the consultation. The CACHE questionnaire showed good internal consistency (0.925). No statistically significant changes in the overall score of CACHE questionnaire between visits were shown. The effect size was 0.016.
Conclusions: The CACHE questionnaire has been shown to be a valid and reliable tool to measure the satisfaction of IBD patients with health care services. The results obtained from the validation process indicated that CACHE is a useful tool for use both in routine clinical practice and clinical studies.