Translation and validation of the COPD Patient Reported Experience Measure (PREM-C9) in Spanish and Catalan

Patient Reported Experience Measures (PREMs) are questionnaires developed to assess the patient experience and incorporate a vision of patient centered care as a new element of value in the quality of healthcare. The PREM-C9 was developed and tested recently in the United Kingdom (UK) for patients with chronic obstructive pulmonary disease (CODP). The aim of the current study was to test the validity and reliability of the PREM-C9 in Spanish and Catalan. 239 patients with COPD completed the PREM-C9 (male 68.9%; female 30.2%). Internal consistency was high for both the Spanish [Cronbach's alpha=0.802] and Catalan [Cronbach's alpha=0.875] versions. Confirmatory Factor Analysis (CFA) proved the item distribution and dimensional structure of the questionnaire except for item2 of the scale "My everyday life with COPD". Goodness-of-fit indices were very close to acceptable values for the CFI/TLI of 0.90. Two of the three hypotheses tested to assess known groups' validity were confirmed, with statistically significant differences found between response categories on the satisfaction (p<0.001) and breathlessness (p = 0.023) scales. No statistically significant differences were observed between the different categories for the education variable. The finding that educational level was not associated with PREM-C9 scores was supported by the results of the multiple regression analysis, which also showed that overall lower levels of overall satisfaction with health services and a greater degree of breathlessness were associated with poorer scores on the PREM-C9. This study has provided evidence for good reliability and structural and construct validity of the Catalan and Spanish versions of the PREM-C9.