Patient Experiences of Continuity of Cancer Care: Development of a New Medical Care Questionnaire (MCQ) for Oncology Outpatients

Objectives: To adapt the Components of Primary Care Index (CPCI) to be applicable to oncology outpatients and to assess the reliability and validity of the adapted instrument (renamed the Medical Care Questionnaire [MCQ]). Methods: The development and validation of the MCQ took place in four phases. Phase 1 reviewed the literature and examined existing measures. In Phase 2, the selected instrument (CPCI) was reviewed by a panel of experts using a stepwise consensus procedure. In Phase 3, the adapted 21-item MCQ was administered to 200 outpatients attending oncology appointments. The instrument was refined to 15 items and in Phase 4, it was completed by 477 oncology outpatients. The psychometric properties of the new instrument were assessed using exploratory factor analysis (EFA), confirmatory factor analysis, multitrait scaling analysis, and by comparing MCQ scores between known groups. Results: EFA of the 15-item MCQ suggested three subscales with acceptable to good reliability: Communication alpha = 0.69; Coordination alpha = 0.84; and Preferences alpha = 0.75. Comparing known groups showed that patients who saw fewer doctors during their clinic visits reported stronger Preferences to see their usual doctor and rated Communication with their doctors as better than patients who saw more doctors during their clinic visits. Conclusion: The MCQ demonstrates good psychometric properties in the target population. It is a brief and simple-to-use instrument, which provides a valid perspective on patients' experiences of communicating with doctors and their perceptions of the continuity and coordination of their cancer care.