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Psychometric Evaluation of the Patient Satisfaction With Logistical Aspects of Navigation (PSN-L) Scale Using Item Response Theory

Carle, Adam C. PhD*; Jean-Pierre, Pascal PhD; Winters, Paul MS; Valverde, Patricia PhD, MPH§; Wells, Kristen PhD; Simon, Melissa MD; Raich, Peter MD#; Patierno, Steven PhD**; Katz, Mira PhD††; Freund, Karen M. MD‡‡; Dudley, Donald MD§§; Fiscella, Kevin MD

doi: 10.1097/MLR.0000000000000089
Original Articles

Background: Patient navigation—the provision of logistical, educational, and emotional support needed to help patients “navigate around” barriers to high-quality cancer treatment offers promise. No patient-reported outcome measures currently exist that assess patient navigation from the patient’s perspective. We use a partial independence item response theory model to report on the psychometric properties of the Patient Satisfaction with Navigation, Logistical measure developed for this purpose.

Methods: We used data from an ethnically diverse sample (n=1873) from the National Cancer Institute Patient Navigation Research Program. We included individuals with the presence of an abnormal breast, cervical, colorectal, or prostate cancer finding.

Results: The partial independence item response theory model fit well. Results indicated that scores derived from responses provide extremely precise and reliable measurement between −2.5 SD below and 2 SD above the mean and acceptably precise and reliable measurement across nearly the entire range.

Conclusions: Our findings provide evidence in support of the Patient Satisfaction with Navigation, Logistical. Scale users should utilize 1 of the 2 described methods to create scores.

*Department of Pediatrics, Cincinnati Children’s Hospital Medical Center & University of Cincinnati, Cincinnati, OH

Department of Psychology, University of Notre Dame, Notre Dame, IN

University of Rochester Medical Center, Rochester, NY

§Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Denver, Denver, CO

Department of Psychology, San Diego State University, San Diego, CA

Departments of Obstetrics and Gynecology and Preventive Medicine, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Northwestern University, Chicago, IL

#Department of Medicine, Denver Health and Hospital Authority, Denver, CO

**Duke Cancer Institute, George Washington University, Washington, DC

††Division of Health Behavior and Health Promotion, College of Public Health, Ohio State University, Columbus, OH

‡‡Institute for Clinical Research and Health Policy Studies, Department of Medicine, Tufts University School of Medicine, Boston, MA

§§Department of Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio, TX

Although Steven Patierno is now at Duke, he was affiliated with George Washington University during data collection.

National Institutes of Health: 5U01CA6903, P30CA016058, UL1RR025755, KL2RR025754, TL1RR025753, 8KL2TR000112-05, 8UL1TR000090-05, 8TL1TR000091-05 and American Cancer Society: 112190-SIRSG-05-253-01.

The authors declare no conflict of interest.

Reprints: Adam C. Carle, PhD, Department of Pediatrics, Cincinnati Children's Hospital Medical Center & University of Cincinnati, 3333 Burnet Ave, Cincinnati, OH 45229. E-mail:

© 2014 by Lippincott Williams & Wilkins.