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Gaceta Sanitaria

Print version ISSN 0213-9111


GARCIA-SUBIRATS, Irene; BEATRIZ ALLER, Marta; VARGAS LORENZO, Ingrid  and  VAZQUEZ NAVARRETE, María Luisa. Adaptation and validation of the CCAENA© scale for the measurement of continuity of care between healthcare levels in Colombia and Brazil. Gac Sanit [online]. 2015, vol.29, n.2, pp.88-96. ISSN 0213-9111.

Objective: To adapt and to validate the scale of the questionnaire Continuity of Care between Care Levels (CCAENA©) in the context of the Colombian and Brazilian health systems. Methods: The study consisted of two phases: 1) adaptation of the CCAENA© scale to the context of each country, which was tested by two pretests and a pilot test, and 2) validation by means of application of the scale in a population survey in Colombia and Brazil. The following psychometric properties were analyzed: construct validity (exploratory factor analysis), internal consistency (Cronbach's alpha and item-rest correlations), the multidimensionality of the scales (Spearman correlation coefficients), and known group validity (chi-square test). Results: Of the 21 items of the original scale, 14 were selected and reformulated based on a statement with response options of agreement to a question with frequency response options. Factor analysis showed that items could be grouped into three factors: continuity across healthcare levels, the patient-primary care provider relationship, and the patient-secondary care provider relationship. Cronbach's alpha indicated good internal consistency (>0.80 in all the scales). The correlation coefficients suggest that the three factors could be interpreted as separated scales (<0.70) and had adequate ability to differentiate between groups. Conclusion: The adapted version of the CCAENA© shows adequate validity and reliability in both countries, maintaining a high equivalence with the original version. It is a useful and feasible tool to assess the continuity of care between healthcare levels from the users' perspective in both contexts.

Keywords : Continuity of patient care; Questionnaires; Outcome and process assessment (health care); Health care delivery; Colombia; Brazil.

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