Aim: The objective of this study was to validate an international instrument addressing family physicians' competency level from the primary health care sers' perspective in Albania, a post-communist country in Southeast Europe.
Methods: This validation study, conducted in March-April 2012, included a sample of 114 primary health care users in Tirana municipality aged 18+ years (49 males and 65 females; mean age: 60 +/- 15 years). All participants were asked to self-assess the level of abilities, skills and competencies of their respective family physicians regarding different domains of quality of health care. Overall, the questionnaire included 37 items organized into 6 subscales/domains. Answers for each item of the tool ranged from 1 ("novice" physicians) to 5 ("expert" physicians). An overall summary score (including 37 items; range: 37-185) and a subscale summary score for each domain were calculated for male and female participants. Socioeconomic data were also collected. Cronbach's alpha was used to assess the internal consistency, and Mann-Whitney U test was used to compare mean scores for the overall scale and each subscale between men and women.
Results: Overall, internal consistency of the whole scale (37 items) was Cronbach's alpha = 0.89; it was higher in women than in men (0.91 vs. 0.82, respectively). The overall summary score for the 37 items of the instrument was 89.3 +/- 9.1; it was slightly higher in women than in men (89.7 +/- 10.6 vs. 88.8 +/- 6.7, respectively, P = 0.218). There were no statistically significant differences in the subscale summary scores between men and women. Overall, there was no correlation of the whole summary score or subscale scores with age. Conversely, there was evidence of a weak positive correlation with educational level.
Conclusions: In the Albanian context, we provide evidence on the process of cross-cultural adaptation of a simple instrument measuring patients' self-perceived level of abilities and competencies of their family physicians regarding different domains of the quality of primary health care services.