Psychometric properties of the GP-Patient Relationship Questionnaire as an instrument for quality improvement in Germany

Abstract

Introduction: Since the patient-doctor relationship (PDR) plays a crucial role in patient primary health care and management, the evaluation of the PDR from both, the patients’ and primary care physicians’, perspectives is an important approach to improve the quality of primary care. However, although there are a variety of questionnaires surveying the patients’ view of the PDR, only few consider the physicians’ perspective. The purpose of this study was to develop a questionnaire that adds the physicians’ perspective to an existing PDR instrument and thus enables a mutual assessment of the relationship. Methods: This study was embedded in a German project aiming at enhancing the adherence in patients with hypertension. Patients and primary care physicians were asked to complete a questionnaire concerning their PDR. The Patient-Doctor Relationship Questionnaire (PDRQ-9) was used to assess the patients’ perspective. For the physicians, the PDRQ-9 items were adapted to the physicians’ perspective resulting in the GP-Patient Relationship Questionnaire (GPPR). The Helping Alliance Questionnaire (HAQ) was used for external validation. Results: A total of 60 physician questionnaires and 50 matched pairs of questionnaires from physicians and patients were included in the analyses. Within the analysis, notable deviations were found for one item, nevertheless the calculated Cronbach's α of 0.89 showed a high internal consistency of the 9-item questionnaire. External validation showed a high correlation of the GPPR with the HAQ, confirming the good psychometric properties demonstrated for the overall instrument. Discussion: Overall, this initial validation study revealed good psychometric properties of the GPPR. A retest will be performed in the course of the overall project to confirm the reliability of the newly developed questionnaire. Conclusion: A new questionnaire to assess the physicians’ perspectives on the PDR was successfully developed to improve adherence-dependent processes of quality improving in primary care.