Cross-cultural Adaptation of an Instrument Measuring Primary Health Care Users’ Perceptions on Competencies of their Family Physicians in Albania

Aim: The objective of this study was to validate an international instrumentaddressing family physicians’ competency level from the primary health careusers’ perspective in Albania, a post-communist country in Southeast Europe.Methods: This validation study, conducted in March-April 2012, included a sampleof 114 primary health care users in Tirana municipality aged 18+ years (49 males and65 females; mean age: 60±15 years). All participants were asked to self-assess the levelof abilities, skills and competencies of their respective family physicians regarding dif-ferent domains of quality of health care. Overall, the questionnaire included 37 itemsorganized into 6 subscales/domains. Answers for each item of the tool ranged from 1(“novice” physicians) to 5 (“expert” physicians). An overall summary score (including 37items; range: 37-185) and a subscale summary score for each domain were calculatedfor male and female participants. Socioeconomic data were also collected. Cronbach’salpha was used to assess the internal consistency, and Mann-Whitney U test wasused to compare mean scores for the overall scale and each subscale between menand women. Results: Overall, internal consistency of the whole scale (37 items) wasCronbach’s alpha=0.89; it was higher in women than in men (0.91 vs. 0.82, respectively).The overall summary score for the 37 items of the instrument was 89.3±9.1; it wasslightly higher in women than in men (89.7±10.6 vs. 88.8±6.7, respectively, P=0.218).There were no statistically significant differences in the subscale summary scoresbetween men and women. Overall, there was no correlation of the whole summaryscore or subscale scores with age. Conversely, there was evidence of a weak positivecorrelation with educational level. Conclusions: In the Albanian context, we provideevidence on the process of cross-cultural adaptation of a simple instrument measuringpatients’ self-perceived level of abilities and competencies of their family physiciansregarding different domains of the quality of primary health care services