Schneider Craig D, Meek Paula M, Bell Iris R
Department of Family Practice, Maine Medical Center, 22 Bramhall St, Portland, ME 04102-3175, USA.
BMC Med Educ. 2003 Aug 28;3:5. doi: 10.1186/1472-6920-3-5.
Complementary/alternative medicine and integrative medicine (CAM/IM) are increasingly used in the U.S. We set out to develop and validate a brief questionnaire measuring health care provider and medical student attitudes regarding these approaches to healthcare.
IMAQ is a 29-item, 7-point Likert scale rated instrument, developed from focus groups consisting of faculty, fellows, visiting residents, and medical students at a university based integrative medicine program. Respondents included 111 (of 574 contacted) internal medicine physicians on an academic medical center CME list and 85 healthcare providers (mostly physicians) attending an American Holistic Medical Association Annual Conference (296 attending). Cohorts were selected for expected differences in attitudes toward CAM/IM.
Factor analysis demonstrated that a 2 factor solution best explained the variance in responses (38%). Factor 1 ("openness to new ideas and paradigms") explained 26% of variance with loadings ranging from 0.79 to 0.3, with factor 2 ("value of both introspection and relationship to patient") contributing an additional 12% of the explained variance with loadings ranging from 0.69 to 0.42. Both factors demonstrated adequate reliability. Factor 1 had a Cronbach's alpha of 0.91, while factor 2 was 0.72. As expected, AHMA conference attendees scored higher (F = 120.00, p < 0.001) than the internists on the IMAQ, supporting the construct validity. Although 63% of the AHMA subjects, and only 32% of the internists were female, analysis revealed that gender did not explain the score differences (F = 2.6, p > 0.05).
Analysis of the IMAQ provided evidence of its reliability and validity in measuring attitudes toward CAM/IM, specifically openness to new ideas and paradigms, and the value of relationship to self and patient. Initial findings support use of the IMAQ in measuring attitudes of students and practitioners towards CAM/IM interventions as a first step in understanding willingness to use these approaches to healing. It is our desire that this preliminary instrument will continue to be refined as the field of CAM/IM matures.
补充/替代医学和整合医学（CAM/IM）在美国的使用越来越广泛。我们着手开发并验证一份简短问卷，以衡量医疗保健提供者和医学生对这些医疗方法的态度。
IMAQ是一份包含29个项目、采用7点李克特量表评分的工具，由一个基于大学的整合医学项目中的教师、研究员、访问住院医师和医学生组成的焦点小组开发。受访者包括学术医学中心继续医学教育名单上的111名（共联系了574名）内科医生，以及参加美国整体医学协会年会的85名医疗保健提供者（大多数是医生）（参会人数为296人）。选择这些群体是因为他们对CAM/IM的态度预期存在差异。
因子分析表明，两因子解决方案能最好地解释回答中的方差（38%）。因子1（“对新思想和范式的开放性”）解释了26%的方差，载荷范围为0.79至0.3，因子2（“内省以及与患者关系的价值”）又贡献了12%的解释方差，载荷范围为0.69至0.42。两个因子都显示出足够的可靠性。因子1的克朗巴哈系数为0.91，因子2为0.72。正如预期的那样，AHMA会议参会者在IMAQ上的得分高于内科医生（F = 120.00，p < 0.001），支持了结构效度。尽管AHMA的受试者中有63%是女性，而内科医生中只有32%是女性，但分析表明性别并不能解释得分差异（F = 2.6，p > 0.05）。
对IMAQ的分析提供了其在测量对CAM/IM态度方面的可靠性和有效性的证据，特别是对新思想和范式的开放性，以及与自我和患者关系的价值。初步研究结果支持使用IMAQ来测量学生和从业者对CAM/IM干预措施的态度，作为理解使用这些治疗方法意愿的第一步。我们希望随着CAM/IM领域的成熟，这个初步工具将不断完善。
