A Developmental Model of Patient Engagement Across Multiracial Society in Klang Valley

Introduction: Patient engagement is an outcome of patients' behaviors caused by various factors such as their experiences as patients, doctors’ services and healthcare policies established by administrators.

Purpose of the study: This study aims to develop a Patient Engagement Model across a multiracial society in Klang Valley.
Methodology: The pilot study randomly sampled 100 patients, 100 doctors, and 50 administrators using self-administered questionnaires. The Exploratory Factor Analysis (EFA) procedure investigated the utility of measuring items and determined the dimensionality of the personalization, access, commitment, and therapeutic alliance constructs. Next, using the newly developed instruments, the field study obtained random samples of 685 patients, 365 doctors, and 90 administrators to survey using the self-administered questionnaires. The field data were used to verify the instruments using the Confirmatory Factor Analysis (CFA) method. The descriptive data of sociodemographics were identified. Finally, Structural Equation Modelling (SEM) was performed to develop and propose a patient engagement model suitable for multiracial societies.
Main Findings: The EFA procedure identified and maintained high factor loading items in the study, the Cronbach alpha for each group’s constructs was found to be higher than 0.5. Overall, the EFA has shown that the questionnaire has relatively good reliability and internal consistency. The CFA procedure verified the instruments measuring Personalization, Access, Commitment, and Therapeutic Alliance constructs for uni-dimensionality, validity, and reliability. The SEM procedure combined the structural models for each group with moderate to good fit and proposed a patient engagement model. The results identified interrelation between constructs and showed that patient engagement was highly influenced by PACT with the R2 of 0.926. 0.944 and 0.890 for the patient, doctor, and administrator groups respectively.
Applications of this study: The result showed that the measurement model of the Patient Engagement constructs achieved moderate to a good fit and should be able to be used in the future of research.
Novelty/Originality of this study: This study developed instruments to assess Patient Engagement specifically among Klang Valley patients and medical personnel. Klang Valley has the highest population of patients and doctors because it was Malaysia's most developed city.