Felix-Aaron Kaytura L, Bone Lee R, Levine David M, Rubin Haya R
Agency of Healthcare Research and Quality, Rockville, MD 20852, USA.
Ethn Dis. 2002 Winter;12(1):87-96.
Because there is no instrument that measures how clients judge community health worker (CHW) services, we sought to develop such a questionnaire. We report how we used client information to develop a brief questionnaire evaluating CHW services.
We conducted and content-analyzed 18 in-depth semi-structured interviews of clients receiving CHW services to determine aspects of care salient to clients. Based on the results of these analyses, we developed and administered an in-person survey measuring the importance of 57 aspects of CHW services to 84 clients in 3 programs using CHWs to help control hypertension or diabetes.
Clients perceived a broad array of aspects of CHW care including CHW attributes, services, benefits or outcomes of service and service arrangements. The 15 aspects ranking highest included: 1) CHW knows job; 2) CHW keeps client alive; 3) CHW gives information on high blood pressure; 4) CHW shows respect; 5) blood pressure is lowered; 6) CHW pays attention; 7) client gets better medical care; 8) CHW speaks understandably; and 9) client gets needed care.
We used client information to generate and determine the relative importance of a pool of aspects that we and others can use to construct brief questionnaires to measure clients' judgments of CHW services. Such questionnaires are needed for ongoing evaluation as more providers and managed care organizations increase their use of CHWs for outreach programs.
由于没有仪器能够测量客户如何评判社区卫生工作者（CHW）的服务，我们试图开发这样一份调查问卷。我们报告了我们如何利用客户信息来开发一份评估CHW服务的简短问卷。
我们对接受CHW服务的客户进行了18次深入的半结构化访谈并进行了内容分析，以确定对客户而言护理中显著的方面。基于这些分析结果，我们开发并实施了一项面对面调查，测量CHW服务的57个方面对3个使用CHW来帮助控制高血压或糖尿病的项目中的84名客户的重要性。
客户认识到CHW护理的广泛方面，包括CHW的属性、服务、服务的益处或结果以及服务安排。排名最高的15个方面包括：1）CHW了解工作；2）CHW使客户存活；3）CHW提供有关高血压的信息；4）CHW表示尊重；5）血压降低；6）CHW予以关注；7）客户获得更好的医疗护理；8）CHW表达清晰易懂；9）客户获得所需护理。
我们利用客户信息生成并确定了一系列方面的相对重要性，我们和其他人可以利用这些方面来构建简短问卷，以测量客户对CHW服务的评判。随着越来越多的提供者和管理式医疗组织在推广项目中更多地使用CHW，进行持续评估需要这样的问卷。
