Development, Validity, and Reliability of the Primary Eye Care Questionnaire (PECQ) Among Optometrists in Malaysia.

Introduction: Visual impairment and vision loss are preventable or treatable if there is access to eyecare services for early detection and if proper interventions are given. Optometrists play a vital role in the early detection of eye and visual-related issues. As healthcare professionals, optometrists are trained to provide comprehensive eye and vision care encompassing dispensing and refraction, detection of abnormalities in the vision and eye, and the rehabilitation of conditions of the visual system, as suggested by the World Council of Optometry.In the current practice of primary eye care, optometrists are not fully utilized and are mostly restricted to refractive correction. Therefore, the optometrists' practice level, scope, and challenges to practice primary eye care must be identified before strengthening optometrists' role in the community.

Objective: The present study aimed to develop and validate a questionnaire to determine the contributing factors and challenges to the practice of primary eye care by optometrists in Malaysia.

Methods: The Primary Eye Care Questionnaire (PECQ) was developed through an extensive literature search to identify the domains and to construct the items. The items were then scrutinized further through focus group discussions with experts (n = 10) from various sectors of eye care. Content validation was conducted with ophthalmologists and optometrists as panels (n = 10), followed by face validation (n = 10) by optometrists from the public and private sectors. Construct validation was performed with exploratory factor analysis and reliability was evaluated by using Cronbach's alpha coefficient and the test-retest reliability.

Results: In total, the PECQ questionnaire was constructed with 123 items under three main domains: contributing factors, challenges, and continuous education. The content validity index (CVI) for each item (I-CVI) score ranged from 0.9 to 1.0 for each item and the CVI for average scale (S-CVI/Ave) was above 0.8 for each domain, with internal consistency of 0.948 and Cronbach's alpha coefficient of 0.971.

Conclusion: The PECQ is a valid and reliable tool for assessing the optometrists' scope of practice, challenges, and contributing factors to the practice of primary eye care.