WHO standards-based tools to measure service providers’ and service users’ views on the quality of hospital child care: development and validation in Italy

ObjectivesEvidence showed that, even in high-income countries, children and adolescents may not receive high quality of care (QOC). We describe the development and initial validation, in Italy, of two WHO standards-based questionnaires to conduct an assessment of QOC for children and young adolescen...

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Published in:	BMJ open Vol. 12; no. 3; p. e052115
Main Authors:	Lazzerini, Marzia, Mariani, Ilaria, de Melo e Lima, Tereza Rebecca, Felici, Enrico, Martelossi, Stefano, Lubrano, Riccardo, Lucarelli, Annunziata, Trobia, Gian Luca, Cogo, Paola, Peri, Francesca, Nisticò, Daniela, Were, Wilson Milton, Baltag, Valentina, Muzigaba, Moise, Barbi, Egidio, Germani, Claudio, Velkoski, Angelika, Balestra, Elia, Castaldo, Benmario, Colle, Alice Del, Valente, Emanuelle Pessa, Cozzi, Giorgio, Amaddeo, Alessandro, Coordinatrice, De Monte Roberta, Coordinatrice, Tamara Strajn, Bicego, Livia, Cassone, Andrea, Schreiber, Silvana, Liguoro, Ilaria, Pilotto, Chiara, Stavro, Lisa, Stefani, Chiara, Moras, Paola, Massarotto, Marcella, Crotti, Paola, Ferro, Benedetta, Pavanello, Riccardo, Bressan, Silvia, Arpone, Marta, Fasoli, Silvia, Carolina, Pelazza, Tagliaferri, Francesco, Coppola, Marta, Grisaffi, Chiara, Mingoia, Elisabetta, Sforzi, Idanna, Santangelo, Rosa, Iuorio, Andrea, Bo, Sara Dal, Marchetti, Federico, Martucci, Vanessa, Sanseviero, Mariateresa, Silvia, Bloise, Marcellino, Alessia, Canzio, Eleonora, Parrino, Roberta, Gambino, Salvatore, Guardino, Melania, Lagalla, Luca, Vaccaro, Beatrice, Rosa, Giuseppina de, Stefano, Vita Antonella Di, Patané, Francesca
Format:	Journal Article
Language:	English
Published:	England British Medical Journal Publishing Group 17-03-2022 BMJ Publishing Group LTD BMJ Publishing Group
Series:	Original research
Subjects:	Adolescent Antibiotics Child Child Care Child mortality Children & youth Coronaviruses COVID-19 Delphi method epidemiology Health facilities Health services High income Hospitals Humans Kappa coefficient Mixed methods research Paediatrics Pain Pediatrics quality in health care Quality of Health Care Quality standards Questionnaires Reproducibility of Results Surveys and Questionnaires Teenagers Validity World Health Organization Italy Europe paediatrics epidemiology quality in health care
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Summary:	ObjectivesEvidence showed that, even in high-income countries, children and adolescents may not receive high quality of care (QOC). We describe the development and initial validation, in Italy, of two WHO standards-based questionnaires to conduct an assessment of QOC for children and young adolescents at inpatient level, based on the provider and user perspectives.DesignMultiphase, mixed-methods study.Setting, participants and methodsThe two questionnaires were developed in four phases equally conducted for each tool. Phase 1 which included the prioritisation of the WHO Quality Measures according to predefined criteria and the development of the draft questionnaires. In phase 2 content face validation of the draft questionnaires was assessed among both experts and end-users. In phase 3 the optimised questionnaires were field tested to assess acceptability, perceived utility and comprehensiveness (N=163 end-users). In phase 4 intrarater reliability and internal consistency were evaluated (N=170 and N=301 end-users, respectively).ResultsThe final questionnaires included 150 WHO Quality Measures. Observed face validity was excellent (kappa value of 1). The field test resulted in response rates of 98% and 76% for service users and health providers, respectively. Among respondents, 96.9% service users and 90.4% providers rated the questionnaires as useful, and 86.9% and 93.9%, respectively rated them as comprehensive. Intrarater reliability was good, with Cohen’s kappa values exceeding 0.70. Cronbach alpha values ranged from 0.83 to 0.95, indicating excellent internal consistency.ConclusionsStudy findings suggest these tools developed have good content and face validity, high acceptability and perceived utility, and good intrarater reliability and internal consistency, and therefore could be used in health facilities in Italy and similar contexts. Priority areas for future research include how tools measuring paediatric QOC can be more effectively used to help health professionals provide the best possible care.
Bibliography:	Original research ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2044-6055 2044-6055
DOI:	10.1136/bmjopen-2021-052115