The Clinicians’ Satisfaction with Clinical Pathway Implementation: Preliminary Development of an Assessment Scale in China

PURPOSE: To develop a satisfaction scale of Chinese clinicians with Clinical Pathway (CP) implementation and evaluate its validity, reliability and item discrimination. MATERIALS AND METHODS: Literature review, in-person interviews, and Delphi were used to design the scale. Data were collected in two phases using random sampling on the spot and an online survey. In the first phase, data from 239 clinicians were investigated in exploratory factor analysis. In the second phase, 513 valid questionnaires were collected and used for confirmatory factor analysis. RESULTS: The scale developed in this study has three dimensions (organization support, process identity, and effect perception) and a total of 21 items. Cronbach’s alpha of each dimension was higher than 0.9. The 3-factor model had enough fitness (χ2/df = 5.602, NFI = 0.926, IFI = 0.938, CFI = 0.938, RFI = 0.914, TLI = 0.929, RMSEA = 0.095, RMR = 0.045). The standardized factor loadings of 21 variables were between 0.742 and 0.949. The average variance extracted (AVE) of each dimension was higher than 0.7, and the construct reliability (CR) of the dimensions was higher than 0.9. The Chi-square difference test results showed that the difference value between the unlimited and limited model of each two potential constructs was higher than 3.84 (P < 0.001). CONCLUSION: The clinicians’ satisfaction scale developed in this study has good construct validity, convergent validity, discriminant validity, internal consistency, and item discrimination. This suggests its usefulness as a tool to assess the satisfaction of clinicians in the implementation of CP in China.