Validation of the French version of the Acceptability E-scale (AES) for mental E-health systems
Introduction
Patient-reported outcomes (PROs), including measures of satisfaction, have gained increasing attention in the mental-health services (Boyer et al., 2009, Crow et al., 2002, Fitzpatrick, 1991). Indeed, patient satisfaction has become one of the important PROs and a contributing outcome in the assessment of health care quality (Zendjidjian et al., 2014b). Patient satisfaction with caregiving is a strong predictor of future behaviors, in particular treatment adherence (Ware and Davies, 1983, Zendjidjian et al., 2014a, Zendjidjian et al., 2014b), and provides important information for improving the quality of health care organizations (Cleary and McNeil, 1988).
Given the increased prevalence of chronic disease, in particular of mental and brain disorders (Wykes et al., 2015), health care organizations now have to deal with the increased use of E-health systems (Chouvarda et al., 2015). Such systems facilitate: i) communication and coordination between patient and healthcare professionals (in primary care and hospital), and ii) medical decisions for diagnosis, prognosis and therapeutic follow-up (Chouvarda et al., 2015). While the extent to which patients are satisfied with E-health systems and find them acceptable should be evaluated, there is a lack of psychometric tools to evaluate it.
The Acceptability E-scale (AES) presents some advantages in the field of patient-reported outcomes in E-health systems (Tariman et al., 2011). It is a generic and validated questionnaire that can accurately evaluate satisfaction with a broad range of E-health systems (Carlson et al., 2001, Mullen et al., 2004, Taenzer et al., 2000), a point that differentiates it from other questionnaires that may have no clear validation process and which focus only on satisfaction with one precise E-health solution. It is also based on 6 items (with a 5-point Likert scale for each item), which is time-efficient and increases its usability in clinical practice. Furthermore, it is a self-reported questionnaire, which is recognized as the most reliable method to measure satisfaction (Crow et al., 2002).
Despite French being the 6th most widely spoken world language with 220 million speakers (Organization International de la francophonie, 2009), the AES has not previously been translated and validated in French. Thus, in order to better evaluate satisfaction with E-health solution in native French speakers, this study sought to design and validate a French version. Translating questionnaires may be dependent on cultural background (Brislin, 1970) so before using any translated questionnaire, a transcultural validation should be undertaken according to specific rules and methods. In the present study we analyzed the psychometric properties of the French AES version in a sample of French patients that was interviewed with a virtual agent, which are the most innovative E-health solution to sustain a clinical evaluation (Philip et al., 2014). In this study, the virtual agents made a clinical evaluation of depressive symptoms.
Section snippets
Participants
Outpatients were recruited by psychiatrists in Bordeaux University Hospital from November 2014 to June 2015 in a consecutive sample design. Inclusion criteria were: native French-speaking adult patients (>18 years) with any type of psychiatric or sleep complaints. Exclusion criteria were: insufficient capacity to consent to and understand and answer the self-report questionnaires.
Gender, age, year of education and antidepressant treatment were noted. Patients were given a clinical interview
Sample characteristics
A total of 178 native French speakers were included. None of the patients reported any difficulties in understanding the items of the AES.
The mean age was 46.51 years old (SD=12.91, range: [19–64] years old), 57.3% (102) were women, the mean number of years of education was 13.36 (SD=3.07), 14.6% (26) were being treated with antidepressant treatment, and 19.7% (35) had a diagnosis of current MDD according to the psychiatrist's evaluation. Age was not significantly different between patients
Discussion
The aim of this study was to translate and validate the French version of the AES in order to make it available for evaluating satisfaction with E-health systems in French-speaking patients. Transcultural validation supported the structural validity of the instrument but revealed some differences with the original version (Tariman et al., 2011).
In the original version, principal component factor analysis found only one factor with all 6 items with a value of item load equal to or greater than
Conflict of interest
We report no conflicts of interest.
Acknowledgments
Special thanks to Muriel Bacarisse, Cédric Valtat, and Aurélien Boiseau for selecting participants, collecting and monitoring data and for administrative, technical, and logistic support. We acknowledge the ANR-PHENOVIRT.
References (32)
- et al.
The client satisfaction questionnaire. Psychometric properties and correlations with service utilization and psychotherapy outcome
Eval. Program. Plan.
(1982) - et al.
Assessment of psychiatric inpatient satisfaction: a systematic review of self-reported instruments
Eur. Psychiatry.
(2009) - et al.
Connected health and integrated care: Toward new models for chronic disease management
Maturitas
(2015) - et al.
A review of guidelines for cross-cultural adaptation of questionnaires could not bring out a consensus
J. Clin. Epidemiol.
(2015) - et al.
Ecological momentary assessment in the investigation of craving and substance use in daily life: a systematic review
Drug Alcohol Depend
(2015) - et al.
Validation and testing of the Acceptability E-scale for web-based patient-reported outcomes in cancer care
Appl. Nurs. Res.
(2011) - et al.
Behavioral consequences of consumer dissatisfaction with medical care
Eval. Program Plan.
(1983) Diagnostic and Statistical Manual of Mental Disorder
(2013)- et al.
Comparison of beck depression inventories -IA and -II in psychiatric outpatients
J. Personal. Assess.
(1996) - Beck A.T., 1996. Inventaire de Dépression de Beck (2ème édition): Manuel du BDI-II. les Éd. du Centre de psychologie...
Etude psychométrique du questionnaire de dépression de Beck auprès d'un échantillon d'étudiants universitaires francophones
Revue can. des sci. du comportement
Back-translation for cross-cultural research
J. Cross Cult. Psychol.
Cross-national epidemiology of DSM-IV major depressive episode
BMC Med.
Relabeling internal and external validity for applied social scientists
New Dir. Program Eval.
Convergent and discriminant validation by the multitrait-multimethod matrix
Psychol. Bull.
A patient survey system to measure quality improvement: questionnaire reliability and validity
Med. Care
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