Questionnaires for Patient Evaluation of Primary Health Care: A Systematic Review and Implications for the Nigerian Practice Setting

Abstract

Background: An increasing number of questionnaires have been developed for patient evaluation of primary health care (PHC) but these are mostly designed for developed countries' settings.
Aim: To review the development, contents, measurement properties of published questionnaires for patient evaluation of PHC and draw implications for the Nigerian practice setting.
Design: A systematic review
Data Sources: Systematic search for worldwide published literature from Medline (1950 to 2014), CINAHL Plus, EMBASE, and PsycINFO databases were concluded on the 30th of April 2014.
Study eligibility criteria: Studies included in this review reported the development and/or validation of a questionnaire for patients' evaluation of primary (health) care.
Data extraction: Data was extracted with a template prepared in accordance with the review objectives. Template had article identifier, setting, context, developmental processes, contents (domains, items, and scales), potential utility and measurement properties (reliability, validity, and acceptability) were extracted and narrative reports were presented.
Findings: Twenty-three studies met all the eligibility criteria for inclusion. The majority were published after 2000 (83%), developed in Europe (61%), and mostly in the United Kingdom (48%). Only 2 (9%) of these questionnaires were developed in countries in Africa. Majority (65%) of these questionnaires were developed through the cycle, contained between 20 – 40 core items (44%) and had bipolar response scale (52%) The most commonly reported measurement index was the Cronbach's alpha (74%) and contents of 58% of questionnaires had scope for potential evaluation of the continuum of structure, process and outcome dimensions of quality. There was no published report on the development or validation of any of these questionnaires for the Nigerian practice setting.
Conclusion: Most questionnaires were developed to suit specific context and practice setting. The wholesome transfer of such questionnaire across cultural and practice setting remains a difficult issue. The limited application of existing questionnaires in the Nigerian PHC setting could be a justification for the development of a contextually sound and conceptually relevant measure for local use.