Self-report questionnaire for measuring presence: development and initial validation.

Background: The concept of 'presence' appears frequently in the literature and seems to be a highly relevant concept in discussing and evaluating quality of relations in healthcare practices. However, no existing self-report measure of presence for health professionals was found.

Purpose: The purpose of this study was (i) to develop a self-report questionnaire for measuring presence and (ii) to conduct initial psychometric testing of the questionnaire.

Method: The process followed two steps. Phase 1 consisted of the development of 64 items that were derived from the 'theory of presence' (ToP) as developed by Andries Baart in the Netherlands in 2001. Face and content validity were completed by a panel of experts in ToP. A pilot study to test understandability was done (N = 22). During Phase 2, 48 remaining items of the Presence Questionnaire for Caregivers (PQ-C) were tested among 723 healthcare professionals. Exploratory principal component analysis was conducted, and reliability coefficients and known-group validity were assessed.

Results: Principal component analysis showed three new components that were labelled 'dedicated attitude', 'openness in perception' and 'reciprocal humaneness'. Thirty-one items were retained which explain 25.4% of the variance. An initial psychometric assessment of the shortened scale showed a Cronbach's alpha of 0.82 and a Spearman-Brown coefficient (for equal length) of 0.63. There were significant differences in sum scores between groups based on age, years of experience and familiarity with ToP.

Conclusion: It appeared possible to develop a self-report questionnaire for measuring presence and establish face and content validity. In initial exploratory factor analysis, the eight theoretical principles of ToP used to develop the questionnaire were not reflected, and three new components appeared. Further research is needed to examine the value of the three new dimensions, and investigation into the construct validity and reliability of the three new components is recommended.