Development and validation of an enhanced PERCCI-S (PERCCI-S-Rev) for measuring person-centred home-based primary care

Background The Person-Centred Community Care Inventory – Swedish version (PERCCI-S) has been used in Swedish municipalities to measure person-centred care in home-based primary care (HBPC) from the patient's perspective since 2021. With use, areas for improvement have emerged. The aim was to develop a revised version that addresses issues identified in practice and incorporates recommendations from the previous validation study while maintaining or improving psychometric properties. A secondary aim was to confirm measurement equivalence of the PERCCI-S to support its use for patients with HBPC alone and those with both HBPC and social care services. Methods Data were collected via two surveys of patients 18 years or older receiving municipal HBPC in Sweden including: a) 1 422 participants who completed the original PERCCI-S in 2023, and b) 1 204 who completed the revised version in 2024. The revised PERCCI-S was developed based on prior feedback and validated based on a series of psychometric and item-response theory analyses comparing the two versions. Results The revised PERCCI-S consists of 12 items. One item was replaced, and three were reworded to emphasize partnership, autonomy, and emotional attunement, core elements of contemporary person-centred care frameworks. Additionally, three items were reworded for clarity. The response scale was changed from four to seven response options. Results of psychometric analyses provide support for the measurement structure of the revised PERCCI-S and measurement equivalence between patients with HBPC alone and those with both HBPC and social care services. The overall scale has good internal consistency reliability ( α = 0.97) and fewer ceiling effects compared to the original. Discussion The revised PERCCI-S (PERCCI-S-Rev) improves on the original with clearer wording and expanded response options that better distinguish patients’ experiences, while maintaining strong psychometric properties.