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Validation of the Patient Assessment of Chronic Illness Care (PACIC) Instrument in the Republic of Srpska, Bosnia and Herzegovina

Natasa Pilipovic-Broceta, Nadja Vasiljevic, Jelena Marinkovic, Nevena Todorovic, Janko Jankovic, Irena Ostric, Dimitra Kalimanovska-Ostric, Maja Racic


Rationale, aims and objectives: To translate, culturally adapt and preliminary validate the original English version of the PACIC questionnaire into the Serbian language, in the Republic of Srpska, Bosnia and Herzegovina and to assess the relationship between PACIC scores and clinical guidelines implementation in family medicine.

Methods: A cross-sectional study was implemented in 2 primary healthcare centers. The translated PACIC questionnaire was administered to 206 consecutive patients with hypertension, diabetes mellitus and/or chronic obstructive pulmonary disease. The validity and reliability of the Serbian version of PACIC has been tested with face validity, construct validity and internal consistency. The PACIC score and its 5 subscales were tested using Kruskal-Wallis or Mann-Whitney test. The relationship of the PACIC score and guidelines implementation was analyzed by multiple linear regression.

Results: The overall PACIC score indicates an implementation of the Chronic Care Model (CCM) occurred “most of the time”. Of the 5 subscales, average scores were highest on “Delivery system/decision support”. CCM in “Follow up/Coordination” occurred sometimes. Cronbach’s alpha coefficient showed a high internal consistency level for the PACIC questionnaire. Kaiser-Meyer-Olkin Measure of Sampling Adequacy is 0.917 and Bartlett’s test of sphericity is significant (p≤0.001). Four factors were identified explaining 69% of total variance.

Conclusions: There was a significant relationship between the PACIC score and the implementation of the chronic disease clinical guidelines. The PACIC questionnaire is advanced as a reliable and internally consistent instrument of use in increasing the person-centeredness of care of chronic illness.


Chronic Care Model (CCM), chronic diseases, cultural adaptation, family medicine, healthcare quality, implementation, PACIC, person-centered healthcare, translation, validation

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