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Validation of the Amharic version of perceived access to healthcare services for patients with cervical cancer in Ethiopia: A second-order confirmatory factor analysis

Author

Listed:
  • Tariku Shimels
  • Biruck Gashawbeza
  • Teferi Gedif Fenta

Abstract

Background: Accessing healthcare services is a multifaceted phenomenon involving various elements, encompassing the demand, identification, reach, and utilization of healthcare needs. The literature offers methods for capturing patients’ perceptions of healthcare access. However, to accurately measure patient perceptions, it is imperative to ensure the validity and reliability of such instruments by designing and implementing localized language versions. Aim: The primary aim of this study was to validate the Amharic version of the perceived access to health-care services among patients diagnosed with cervical cancer in Ethiopia. Method: A cross-sectional study was conducted among cervical cancer patients at oncology centers in Addis Ababa, Ethiopia. A consecutive sampling approach was used and data collection took place from January 1 to March 30, 2023. Following initial validation and pretesting, a KoboCollect mobile phone application was employed for data collection. Subsequently, the collected data underwent cleaning in Microsoft Excel and analysis through Amos software v.26 and R programming. Various validity and reliability tests, such as content validity, convergent validity, face validity, divergent validity, known-group validity, and reliability tests, were executed. A second-order confirmatory factor analysis was developed to calculate incremental model fit indices, including CFI and TLI, along with absolute measures, namely SRMR and RMSEA. Results: A total of 308 participants were involved in the study, with 202 (65.6%) being patients referred from outside Addis Ababa. The initial evaluation of content validity by expert panels indicated that all criteria were met, with a CVR range of 0.5 to 1, I-CVI values ranging from 0.75 to 1, an S-CVI value of 0.91, and face validity values ranging from 2.4 to 4.8. The internal consistency of items within the final constructs varied from 0.76 to 0.93. Convergent, known-group, and most divergent validity tests fell within acceptable fit ranges. Common incremental fit measures for CFI and TLI were achieved with corresponding values of 0.95 and 0.94, respectively. The absolute fit measures of SRMR and RMSEA were 0.04 and 0.07, indicating good and moderate fit, respectively. Conclusion: The study indicated a high internal consistency and validity of items with good fit to the data, suggesting potential accuracy of the domains. A five-domain structure was developed which enables adequate assessment of perceived access to health-care services of patients with cervical cancer in Ethiopia. We suggest that the tool can be utilized in other patient populations with a consideration of additional constructs, such as geographic accessibility.

Suggested Citation

  • Tariku Shimels & Biruck Gashawbeza & Teferi Gedif Fenta, 2024. "Validation of the Amharic version of perceived access to healthcare services for patients with cervical cancer in Ethiopia: A second-order confirmatory factor analysis," PLOS ONE, Public Library of Science, vol. 19(5), pages 1-22, May.
    • Handle: RePEc:plo:pone00:0300815
    DOI: 10.1371/journal.pone.0300815
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    References listed on IDEAS

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    1. Seman K. Ousman & Jeanette H. Magnus & Johanne Sundby & Mekdes K. Gebremariam, 2020. "Uptake of Skilled Maternal Healthcare in Ethiopia: A Positive Deviance Approach," IJERPH, MDPI, vol. 17(5), pages 1-22, March.
    2. World Bank, 2022. "Poverty and Shared Prosperity 2022," World Bank Publications - Books, The World Bank Group, number 37739, April.
    3. Abraha Woldemichael & Amirhossein Takian & Ali Akbari Sari & Alireza Olyaeemanesh, 2019. "Availability and inequality in accessibility of health centre-based primary healthcare in Ethiopia," PLOS ONE, Public Library of Science, vol. 14(3), pages 1-16, March.
    4. Philip Dalinjong & Alexander Laar, 2012. "The national health insurance scheme: perceptions and experiences of health care providers and clients in two districts of Ghana," Health Economics Review, Springer, vol. 2(1), pages 1-13, December.
    5. Cylus, Jonathan & Papanicolas, Irene, 2015. "An analysis of perceived access to health care in Europe: How universal is universal coverage?," Health Policy, Elsevier, vol. 119(9), pages 1133-1144.
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