The PCCQ-27 is a multidimensional measurement instrument designed to assess patients' experiences of continuity of care in connection with hospital discharge. Continuity of care refers to care that is coordinated, cohesive, and aligned with the patient's needs and preferences. Continuity during the hospital discharge process is particularly important, as the risk of fragmentation of care is high since care often continues in the form of follow-ups with other healthcare providers.
Continuity of care refers to the degree to which healthcare services are coordinated, coherent, and connected over time. The Patient Continuity of Care Questionnaire (PCCQ) enables the measurement of continuity of care after hospitalization from the patient鈥檚 perspective.
The PCCQ is a generic questionnaire initially constructed and validated in Canada by Professor Hadjistavropoulos [1]. The PCCQ includes the different aspects of continuity of care; informational, relational and management continuity.
relationships with providers in the hospital
relationships with providers in the community
management of written forms
management of follow-up
management of communication
The response options are on a 5-point Likert Type scale, with an additional option to respond 鈥渘ot applicable鈥�. Higher scores indicate a greater degree of perceived continuity.
For access to PCCQ-12, please contact emma.safstrom@liu.se
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If you wish to translate the PCCQ-12, please contact emma.safstrom@liu.se
Any translation should follow the recommended process of translation and cultural adaptation [5, 6].
1) Forward translation鈥攖ranslation of the original language (English) to the target language. It is generally recommended that the forward translators should have the 鈥榥ew language鈥� as their mother tongue. One translator should have expertise in the topic (e.g., nurse, health care professional), and the second is a language expert, but naive about healthcare. The translators should work independently from each other and be instructed to stay close to the English version.
2) Reconciliation鈥攃omparing and merging more than one forward translation into a single forward translation. Discuss possible differences and use the words that are closest to the original English version's meaning.
3) Back translation鈥攖ranslation of the new language version back into the original language. Recruit two new translators for the backward translation: 鈥楴ew language鈥� (from step 1) to English. The back translators should have English as their mother tongue. They should be blinded to the original version of the questionnaire. The back translators should work independently of each other.
4) Back translation review鈥攃omparison of the back-translated versions of the instrument with the original to highlight and investigate discrepancies between the original and the reconciled translation, which is then revised in the process of resolving the issues.
5) Harmonization鈥攃omparison of back translations of multiple language versions with each other and the original instrument to highlight discrepancies between the original and its derivative. It is recommended to contact the constructor (or Emma S盲fstr枚m) for this step.
6) Cognitive debriefing鈥攖esting the instrument on a small group of relevant patients or lay people in order to test alternative wording and to check the understandability, interpretation, and cultural relevance of the translation. This could be done through think-aloud interviews. Pay attention to semantic and idiomatic, and conceptual equivalence.
7) Review of cognitive debriefing results and finalization鈥攃ompare the patients鈥� or lay persons鈥� interpretation of the translation with the original version to highlight and amend discrepancies.
8) Proofreading鈥攆inal review of the translation to highlight and correct any typographic, grammatical or other errors;
9) Final report. It should be published in an English-language peer-reviewed scientific journal
1. Hadjistavropoulos, H., et al., Patient perceptions of hospital discharge: reliability and validity of a Patient Continuity of Care Questionnaire. Int J Qual Health Care, 2008. 20(5): p. 314-23.
2. S盲fstr枚m, E., et al., Development and psychometric properties of a short version of the Patient Continuity of Care Questionnaire. Health Expect, 2023. 26(3): p. 1137-1148.
3. Chen, H.M. and C.M. Chen, A Chinese version of the Patient Continuity of Care Questionnaire: reliability and validity assessment. J Clin Nurs, 2016.
4. Facchinetti, G., et al., Information before discharge in geriatric patients in Italy: cultural adaptation and validation of the Patient Continuity of Care Questionnaire. European Journal of Ageing, 2021. 18(1): p. 99-107.
5. Beaton, D.E., et al., Guidelines for the process of cross-cultural adaptation of self-report measures. Spine, 2000. 25(24): p. 3186-3191.
6. Wild, D., et al., Principles of Good Practice for the Translation and Cultural Adaptation Process for Patient-Reported Outcomes (PRO) Measures: report of the ISPOR Task Force for Translation and Cultural Adaptation. Value Health, 2005. 8(2): p. 94-104.
Continuity of care refers to the degree to which healthcare services are coordinated, coherent, and connected over time. The Patient Continuity of Care Questionnaire (PCCQ) enables the measurement of continuity of care after hospitalization from the patient鈥檚 perspective.
The PCCQ is a generic questionnaire initially constructed and validated in Canada by Professor Hadjistavropoulos [1]. The PCCQ includes the different aspects of continuity of care; informational, relational and management continuity.
There are six subscales of the PCCQ:
information transfer to patientsrelationships with providers in the hospital
relationships with providers in the community
management of written forms
management of follow-up
management of communication
The response options are on a 5-point Likert Type scale, with an additional option to respond 鈥渘ot applicable鈥�. Higher scores indicate a greater degree of perceived continuity.
There are different versions of the questionnaire:
PCCQ-27:
This version includes 27 statements that together form six subscales. Each scale is calculated separately by summing the responses within the respective scale and dividing the sum by the number of questions in the scale. Thus, each scale can range from 1 to 5. Higher scores indicate a higher degree of perceived continuity [1]PCCQ-12:
A unidimensional shorter version of the PCCQ consisting of 12 statements. A total score can be calculated for this version. It was developed and validated in Sweden [2].For access to PCCQ-12, please contact emma.safstrom@liu.se
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Other languages
PCCQ, or parts of the instrument, has been translated into Chinese and Italian versions. [3, 4]Translation of the PCCQ
If you wish to translate the PCCQ, please contact heather.hadjistavropoulos@uregina.caIf you wish to translate the PCCQ-12, please contact emma.safstrom@liu.se
Any translation should follow the recommended process of translation and cultural adaptation [5, 6].
1) Forward translation鈥攖ranslation of the original language (English) to the target language. It is generally recommended that the forward translators should have the 鈥榥ew language鈥� as their mother tongue. One translator should have expertise in the topic (e.g., nurse, health care professional), and the second is a language expert, but naive about healthcare. The translators should work independently from each other and be instructed to stay close to the English version.
2) Reconciliation鈥攃omparing and merging more than one forward translation into a single forward translation. Discuss possible differences and use the words that are closest to the original English version's meaning.
3) Back translation鈥攖ranslation of the new language version back into the original language. Recruit two new translators for the backward translation: 鈥楴ew language鈥� (from step 1) to English. The back translators should have English as their mother tongue. They should be blinded to the original version of the questionnaire. The back translators should work independently of each other.
4) Back translation review鈥攃omparison of the back-translated versions of the instrument with the original to highlight and investigate discrepancies between the original and the reconciled translation, which is then revised in the process of resolving the issues.
5) Harmonization鈥攃omparison of back translations of multiple language versions with each other and the original instrument to highlight discrepancies between the original and its derivative. It is recommended to contact the constructor (or Emma S盲fstr枚m) for this step.
6) Cognitive debriefing鈥攖esting the instrument on a small group of relevant patients or lay people in order to test alternative wording and to check the understandability, interpretation, and cultural relevance of the translation. This could be done through think-aloud interviews. Pay attention to semantic and idiomatic, and conceptual equivalence.
7) Review of cognitive debriefing results and finalization鈥攃ompare the patients鈥� or lay persons鈥� interpretation of the translation with the original version to highlight and amend discrepancies.
8) Proofreading鈥攆inal review of the translation to highlight and correct any typographic, grammatical or other errors;
9) Final report. It should be published in an English-language peer-reviewed scientific journal
1. Hadjistavropoulos, H., et al., Patient perceptions of hospital discharge: reliability and validity of a Patient Continuity of Care Questionnaire. Int J Qual Health Care, 2008. 20(5): p. 314-23.
2. S盲fstr枚m, E., et al., Development and psychometric properties of a short version of the Patient Continuity of Care Questionnaire. Health Expect, 2023. 26(3): p. 1137-1148.
3. Chen, H.M. and C.M. Chen, A Chinese version of the Patient Continuity of Care Questionnaire: reliability and validity assessment. J Clin Nurs, 2016.
4. Facchinetti, G., et al., Information before discharge in geriatric patients in Italy: cultural adaptation and validation of the Patient Continuity of Care Questionnaire. European Journal of Ageing, 2021. 18(1): p. 99-107.
5. Beaton, D.E., et al., Guidelines for the process of cross-cultural adaptation of self-report measures. Spine, 2000. 25(24): p. 3186-3191.
6. Wild, D., et al., Principles of Good Practice for the Translation and Cultural Adaptation Process for Patient-Reported Outcomes (PRO) Measures: report of the ISPOR Task Force for Translation and Cultural Adaptation. Value Health, 2005. 8(2): p. 94-104.