Development and Validation of a Cloud Follow-up Service Experience Scale for Patients with Chronic Diseases

Background Follow-up is a necessary step in the management of chronic disease patients. Cloud follow-up as a new form of follow-up may improve the quality of follow-up. However, there is currently a lack of patient-oriented evaluation tools for cloud follow-up service quality. Objective To develop a scale for evaluating the service experience of chronic disease patients in cloud follow-up and to examine its reliability and validity, in order to provide a tool for evaluating the quality of cloud follow-up services. Methods Guided by the service quality evaluation model, the scale was developed by using methods including literature review, semi-structured interview, expert consultation. During August to October 2022, a survey was conducted among chronic disease patients (n=480) discharged from a tertiary hospital and lived under the network of a community service center in Hangzhou, China. Item analysis and tests of reliability and validity were test on the developed scale. Results The developed scale for evaluating the service experience of chronic disease patients in cloud follow-up had 37 items distributed in 5 dimensions. Patients' perceptions and expectations to each item were evaluated simultaneously. The overall Cronbach's α coefficient of the developed scale was 0.962, with split-half reliability of 0.732 and test-retest reliability of 0.844. The content validity index of the scale was 0.980. The correlation coefficient between the scale and satisfaction scores was 0.754 (P<0.01). Confirmatory factor analysis showed good fit of the scale. The factor loading coefficients of the scale items ranged from 0.514 to 0.988 (P<0.001), the composite reliabilities of the dimensions ranged from 0.947 to 0.987, and the average variance extracted (AVE) ranged from 0.693 to 0.947. The correlation coefficients between dimensions were all smaller than the square root of the corresponding AVE. Conclusion The scale for evaluating the service experience of chronic disease patients in cloud follow-up, developed in this study, demonstrated good reliability and validity. It can be used to evaluate the experience of chronic disease patients in cloud follow-up services.