Abstract
Background
Medical visit accompaniment (MVA) services can help older outpatients navigate complex outpatient care processes by providing continuous accompaniment and non-clinical assistance throughout the visit. Existing measures and studies have focused on willingness to use MVA services or preferences for specific service attributes, while validated tools for assessing older outpatients’ multidimensional MVA service needs remain limited. This study aimed to develop and psychometrically evaluate the Medical Visit Accompaniment Service Needs Scale for older outpatients (MVASNS).
Methods
Based on a conceptual framework integrating ERG theory, findings from our previous qualitative study, and evidence from the literature, the initial item pool was refined through two-round Delphi expert consultation and pilot testing. From April to July 2026, 764 older outpatients were recruited from two tertiary hospitals and one community health service centre in Zhejiang Province, China. After quality screening, 739 valid questionnaires were randomly divided into exploratory (n = 369) and confirmatory (n = 370) samples. Psychometric evaluation included content validity, item analysis, structural validity, convergent and discriminant validity, internal consistency, split-half reliability, and test–retest reliability. Floor and ceiling effects were also examined.
Results
The preliminary 33-item version showed satisfactory content validity (S-CVI/Ave = 0.949). Two items were removed during exploratory factor analysis, yielding a 31-item scale with three domains: basic service needs (12 items), emotional support and learning needs (8 items), and service quality needs (11 items). The three factors explained 52.825% of the total variance, and exploratory graph analysis identified item groupings consistent with this three-factor solution. Confirmatory factor analysis supported the three-factor structure with acceptable model fit (robust CFI = 0.950, robust TLI = 0.946, robust RMSEA = 0.055, and SRMR = 0.037). Convergent and discriminant validity were satisfactory. The total-scale Cronbach’s α was 0.962, the Spearman–Brown coefficient was 0.968, and the test–retest ICC was 0.927 (95% CI 0.816–0.968). No substantial floor or ceiling effects were observed for the total scale or its domains.
Conclusions
The MVASNS showed initial evidence of validity and reliability for assessing older outpatients’ MVA service needs.
Clinical trial number
Not applicable.
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Acknowledgements
The authors gratefully acknowledge all research participants, as well as the staff of the participating hospitals and community health service centre, for their support in participant recruitment and data collection.
Funding
This work was supported by the Scientific Research Fund Project of the National Health Commission of the People’s Republic of China (WKJ-ZJ-2304) and the College Students’ Innovation and Entrepreneurship Training Program of Zhejiang Province (S202610346028).
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The study was approved by the Ethics Committee of Sir Run Run Shaw Hospital, Zhejiang University School of Medicine (approval no. 2025-4094-01), the Research Ethics Committee of the Affiliated Hospital of Hangzhou Normal University (approval no. 2025(E2)-KS-231), and the Ethics Committee of the School of Public Health and Nursing, Hangzhou Normal University (approval no. 2025079). The study was conducted in accordance with the Declaration of Helsinki. All participants provided informed consent and participated voluntarily.
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The authors declare no competing interests.
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Chen, Y., Tang, Z., Sun, Y. et al. Development and psychometric evaluation of the medical visit accompaniment service needs scale for older outpatients (MVASNS). BMC Geriatr (2026). https://doi.org/10.1186/s12877-026-08651-9
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DOI: https://doi.org/10.1186/s12877-026-08651-9