Comprehensive approach in family medicine: A scale development study

The aim of this study was to develop a valid, reliable and usable scale assessing the core competency of comprehensive approach which is one of the core competencies in family medicine. A pool of items was created under the headings of simultaneous management of acute and chronic diseases; health promotion and disease prevention; coordination of treatment, care, rehabilitation and palliation. This item pool was reduced to 45 items and finalized as a result of development group evaluations, expert opinions and pilot implementation. Data from 237 active family physicians obtained through an online survey were used for validity and reliability analyses. As a result of the factor and item analyses, 6 items were removed and the analyses were completed with the final scale form consisting of 39 items. At the end of the exploratory factor analysis, a working structure with seven factors was obtained. The quality of the items was evaluated through item analysis. It was found that the items showed adequate agreement with each other and with the whole scale. Item discrimination was found to be at a good level. Internal consistency analyses were conducted to determine reliability. Cronbach's alpha value for the whole scale was found to be 0.948. This value indicates a high level of reliability. Cronbach's alpha changes in case of item removal and the analysis of dividing the test into two equal halves also support the reliability of the scale. For the continuation of the research, it is planned to conduct another application with a large sample group, to repeat the validity and reliability analyses of the scale with this data, to re-evaluate the factor structures and factor names, to confirm the factor structures with confirmatory factor analysis and to conduct test-retest reliability analysis if possible. In this study, as many methods as possible were included as evidence for the validity and reliability of the developed scale. It is possible to increase this evidence with more applications. However, in its current form, it can be a resource for defining and evaluating the comprehensive approach in family medicine and a guide for future studies on core competencies.