Translating and testing the reliability of the adult primary care assessment toll into Maltese

Abstract

Translating and Testing the Reliability of the Adult Primary Care Assessment Tool into Maltese. Fabrizia Azzopardi MD. General Practice Trainee Master's student in Family Medicine University of Malta Medical School Faculty of Medicine and Surgery Department of Family Medicine fabriziaazzopardi@gmail.com Aim: To translate and test the reliability of the Primary Care Assessment Tool in Maltese. The Adult Primary Care Assessment Tool (PCAT) is a Validated Tool originating from Johns Hopkins School of Public Health and Hygiene in the University of South Carolina, Columbia. Method: Permission to use the Adult Primary Care Assessment Tool (PCAT) was obtained from the Johns Hopkins School of Public Health and Hygiene. Forward and backward translations were then carried out by bilingual persons proficient in translations. The translated versions of the PCAT were then reviewed so that a final consensus translation in Maltese was obtained. Pilot testing was carried out on 3 patients by convenience sampling. The tool was then administered to a random sample of sixty-eight patients. All interviews were conducted by telephone. Re-test administration of the tool was carried out 2 to 4 weeks later. Test-Retest Reliability was established by working out Cronbach alpha and Intraclass correlation coefficient (ICC) for each item between initial and retest administration results. Cronbach alpha together with Spearman-Brown coefficient and Guttman Split-Half Coefficient were worked out to study Internal Consistency. Results: Out of a total of 68 randomly identified individuals a total of 45 (66.2%) answered the tool on both test and retest administration. The average number of days between test and retest administration was 12.58days. First time interviews took an average of 23.50 minutes to carry out. Retest administration of the tool took an average of 12.58 minutes. Results showed that most questions were reliable on testretest administration with a Cronbach alpha result above 0.7 however sections G and H dealing with Comprehensiveness of Services A vailable/Provided had low Cronbach alpha results. Internal consistency results showed that Family Centeredness and Community Orientation had low Cronbach alpha results of 0.495 and 0.616 respectively. Despite this, Cronbach's alpha for the primary care score was 0.784 suggesting that a good level of internal consistency reliability was achieved. Conclusions: Further changes to the Maltese version of the PCAT are necessary. Changes required reflect cultural differences and not translation problems. Re-pilot testing of the questionnaire will be necessary to confirm that changes are adequate.