R Salido-Vallejo1, M González-Velasco2, M Guilabert3, E I García4, J J Mira5. 1. Hospital Reina Sofía de Córdoba, Córdoba, España. 2. Vocalía de Dermofarmacia del Colegio Oficial de Farmacéuticos de Sevilla, Sevilla, España. 3. Universidad Miguel Hernández, Elche, España. Electronic address: mguilabert@umh.es. 4. Universidad de Cádiz, Cádiz, España. 5. Universidad Miguel Hernández, Elche, España; Departamento de Salud Alicante Sant Joan, Alicante, España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), España.
Abstract
OBJECTIVE: To analyse barriers limiting an integral approach in the care process of patients with actinic keratosis, and to validate a questionnaire of their perception in order to assess this approach. METHOD: A qualitative study (Focus Group) was conducted to assess the perception of the healthcare process of professionals (dermatologists, family doctors, nurses, pharmacists and managers), and patients. A validation study of a new tool was conducted, defining the scope and contents of a questionnaire of perceived quality. Reliability, consistency and validity were analysed after inviting a convenience sample of 225 patients to respond. RESULTS: Underdiagnosis in primary care, a higher variability in resources, and access to the health care circuit, together with gaps in patient information about actinic keratosis, are relevant barriers to achieve comprehensive care in this disease condition. The result of the focus groups advised to elaborate 14 reactive items. A total of 224 patients responded (mean age 71.6, SD 11.1), of which 153 (68%) were men. Two factors were isolated including 12 items (explained variance of 58%). The consistency of this factorial solution was .87, the split-half reliability being .76, with the scores in the factors showing an adequate predictive capacity. CONCLUSIONS: The coordination between levels and to reduce to variability in equipment and clinical decision making in Primary Care are the most prominent barriers. The questionnaire has appropriate metric properties and it explores the information and care by the medical staff and the information and advice provided by the pharmacist.
OBJECTIVE: To analyse barriers limiting an integral approach in the care process of patients with actinic keratosis, and to validate a questionnaire of their perception in order to assess this approach. METHOD: A qualitative study (Focus Group) was conducted to assess the perception of the healthcare process of professionals (dermatologists, family doctors, nurses, pharmacists and managers), and patients. A validation study of a new tool was conducted, defining the scope and contents of a questionnaire of perceived quality. Reliability, consistency and validity were analysed after inviting a convenience sample of 225 patients to respond. RESULTS: Underdiagnosis in primary care, a higher variability in resources, and access to the health care circuit, together with gaps in patient information about actinic keratosis, are relevant barriers to achieve comprehensive care in this disease condition. The result of the focus groups advised to elaborate 14 reactive items. A total of 224 patients responded (mean age 71.6, SD 11.1), of which 153 (68%) were men. Two factors were isolated including 12 items (explained variance of 58%). The consistency of this factorial solution was .87, the split-half reliability being .76, with the scores in the factors showing an adequate predictive capacity. CONCLUSIONS: The coordination between levels and to reduce to variability in equipment and clinical decision making in Primary Care are the most prominent barriers. The questionnaire has appropriate metric properties and it explores the information and care by the medical staff and the information and advice provided by the pharmacist.