Assessing measurement invariance of the SEGUE framework among Chinese and Ghanaian patients: A cross-sectional study

OBJECTIVE: Measurement invariance assesses the psychometric equivalence of a construct across groups or across time. This study aimed to find out whether the newly modified 5-point Likert scale SEGUE Framework for evaluating doctor's communication skills demonstrates measurement invariance among Chinese and Ghanaian patients. METHODS: Measurement invariance tests were conducted using two samples collected from the two cultures respectively (China: N = 598 and Ghana: N = 591). Confirmatory Factor Analysis (CFA) was used to test for the factor structure. Multiple-group CFA was used to test the measurement invariance of the SEGUE between the two samples. RESULTS: The same five-factor model showed acceptable model fit in both Chinese and Ghanaian samples. Cross-cultural measurement invariance tests revealed that scalar invariance was observed across the two samples. CONCLUSION: Cross-cultural adaptations of instruments should exhibit measurement invariance to ensure that measures are interpreted and used consistently. Findings of our study suggest that the SEGUE Framework is invariant across the two cultures, which increases confidence in data collection and comparison. INNOVATION: This is the first study to establish measurement invariance among Chinese and Ghanaians using the SEGUE Framework which assesses doctors' communication from patients' perspectives.