Cultural validation of CQI-measurements measuring minority ethnic patients’ perspective on quality of care.

Background: In improving quality of healthcare it is important to take patients’ perspective into account. In the Netherlands, the Consumer Quality Index (CQI) is used for this, though entirely based on a native Dutch perspective. Minority ethnic patients may have different needs. This study assessed whether CQI instruments successfully capture their care experiences, and whether CQI’s are applicable to them. Methods: 12 Focus group discussions with Surinamese, Antillean, Turkish and Moroccan patients were held, and discourse-analysed using MAXQDA. Applicability of the questionnaires was tested using think-aloud interviews (N=45). Findings: Focus group participants (N=94; 62% women) agreed that the CQI covered all quality-of-care themes important to them, but requested additional culture sensitive items. The think-aloud interviews revealed that considerable adjustments were required. Discussion: The concept of ‘quality of care’ does not substantially differ between minority ethnic and native Dutch patients. Think-aloud interviews proved highly valuable in the process of questionnaire design.