Jenkinson C, Coulter A, Bruster S, Richards N
Picker Institute Europe, King's Mead House, Oxpens Road, Oxford OX1 1RX.
Qual Life Res. 2002 Dec;11(8):721-7. doi: 10.1023/a:1020818500819.
Analysis of data from the National Survey of Coronary Heart Disease patients to develop a core measure of patient experiences of health care. A secondary purpose was to determine whether a single summary index figure could be generated from the instrument.
The data reported here comes from the survey of coronary heart disease (CHD) patients, which was the second in the programme of National Surveys of National Health Service (NHS) patients. It took place during 1999. After an in-patient episode for CHD, questionnaires were mailed out to patients with a covering letter and a pre-paid stamped addressed envelope. Those patients who did not reply within two weeks of the initial mailing were sent a reminder letter and, if this elicited no reply within two weeks, they were sent another copy of the questionnaire.
Of the 116,872 patients who were sent questionnaires, 3399 proved to be ineligible or out-of scope to the survey. Responses were gained from 84,310 (74.3% of eligible respondents).
Reliability analysis supported the existence of seven dimensions which seem to be tapping distinct underlying phenomena: hospital environment, information and communication, patient involvement, coordination of care, discharge and transition, and pain. Higher order factor analysis indicated these dimensions constituted one factor and, consequently, can be summed to create an index figure. The construct validity of the measure was assessed, and it distinguished between groups as was hypothesised.
The dimensions of the questionnaire have high internal reliability. Both the dimensions of the instrument and the index score were found to have high construct validity. The instrument provides a core set of issues that should be covered when assessing the quality of care for hospital patients with coronary heart disease.
分析来自全国冠心病患者调查的数据,以制定一项衡量患者医疗体验的核心指标。第二个目的是确定是否可以从该工具生成一个单一的综合指标数字。
此处报告的数据来自冠心病(CHD)患者调查,这是国家医疗服务体系(NHS)患者全国调查计划中的第二项调查。调查于1999年进行。在冠心病患者住院治疗后,向患者邮寄问卷,并附上说明信和预付邮资的回邮信封。那些在首次邮寄后两周内未回复的患者会收到一封催复信,如果在接下来的两周内仍未得到回复,会再次向他们发送问卷副本。
在被发送问卷的116,872名患者中,有3399名被证明不符合调查资格或超出调查范围。共收到84,310份回复(占符合条件受访者的74.3%)。
可靠性分析支持存在七个维度,这些维度似乎反映了不同的潜在现象:医院环境、信息与沟通、患者参与、护理协调、出院与转诊以及疼痛。高阶因子分析表明这些维度构成一个因子,因此,可以将它们相加得出一个指标数字。对该测量工具的结构效度进行了评估,结果表明它能够如假设的那样区分不同组。
问卷的各个维度具有较高的内部可靠性。该工具的维度和指标得分均具有较高的结构效度。该工具提供了一组核心问题,在评估冠心病住院患者的护理质量时应涵盖这些问题。