Nijmegen Continuity Questionnaire: Development and testing of a questionnaire that measures continuity of care

ObjectiveTo develop and pilot test a generic questionnaire to measure continuity of care from the patient’s perspective across primary and secondary care settings.Study Design and SettingWe developed the Nijmegen Continuity Questionnaire (NCQ) based on a systematic literature review and analysis of 30 patient interviews. The questionnaire consisted of 16 items about the patient–provider relationship to be answered for five different care providers and 14 items each on the collaboration between four groups of care providers. The questionnaire was distributed among patients with a chronic disease recruited from general practice. We used principal component analysis (PCA) to identify subscales. We refined the factors by excluding several items, for example, items with a high missing rate.ResultsIn total, 288 patients filled out the questionnaire (response rate, 72%). PCA yielded three subscales: “personal continuity: care provider knows me,” “personal continuity: care provider shows commitment,” and “team/cross-boundary continuity.” Internal consistency of the subscales ranged from 0.82 to 0.89. Interscale correlations varied between 0.42 and 0.61.ConclusionThe NCQ shows to be a comprehensive, reliable, and valid instrument. Further testing of reliability, construct validity, and responsiveness is needed before the NCQ can be more widely implemented.