Psychometric performance of the OECD Patient-Reported Indicator Surveys Patient Questionnaire (PaRIS-PQ) among adults with chronic conditions in Norway

PURPOSE: The OECD Patient-Reported Indicator Surveys (PaRIS) initiative aims to provide standardised, internationally comparable patient-reported indicators for people living with chronic conditions receiving primary or generalist ambulatory care. This study evaluated the psychometric performance of the multi-item scales in the Norwegian PaRIS Patient Questionnaire (PaRIS-PQ). METHODS: Data were drawn from the 2023 Norwegian PaRIS Main Survey. Respondents aged ≥ 45 years with at least one self-reported chronic condition were included. Measures were PROMIS Global Physical Health, PROMIS Global Mental Health, and WHO-5 Well-Being Index as patient-reported outcome measures (PROMs); the Person-Centred Coordinated Care Experience Questionnaire (P3CEQ) as a patient-reported experience measure (PREM); and the Porter-Novelli Scale (PNS) and self-management confidence as capability-related measures. Analyses assessed structural validity, internal consistency reliability, measurement invariance, item functioning, and construct validity. RESULTS: Of 8,683 respondents, 6,691 reported at least one chronic condition. PROM scales performed best, with acceptable internal consistency (α = 0.80-0.89) and strongest confirmatory support for PROMIS Global Physical Health (CFI = 0.992, RMSEA = 0.080). The PREM (P3CEQ) showed weaker performance, with suboptimal fit for the total scale (CFI = 0.818, RMSEA = 0.132), limited scalar invariance, and low internal consistency for the care coordination subscale (α = 0.61). Capability-related measures showed mixed performance. Metric invariance was supported across all tested models, whereas scalar invariance was less consistent. Construct validity findings were consistent with expectations. CONCLUSION: PROM scales showed the most consistent psychometric support. PREM and capability-related measures were more heterogeneous and require cautious, scale-specific interpretation, especially in subgroup comparisons and when used as latent measures. Evaluation and refinement of weaker experience- and capability-related measures is warranted.