Temkin-Greener Helena, Gross Diane, Kunitz Stephen J, Mukamel Dana
Department of Community and Preventive Medicine, University of Rochester, School of Medicine, Rochester, New York, USA.
Med Care. 2004 May;42(5):472-81. doi: 10.1097/01.mlr.0000124306.28397.e2.
The objectives of this study were to test the reliability and the validity of a survey instrument for assessing interdisciplinary team performance in long-term care settings and to measure team performance in the Program of All-Inclusive Care for the Elderly (PACE).
The analysis is based on 1220 surveys completed by team members of 26 PACE programs. Cronbach's alphas, analysis of variance, and regression models were used to assess the reliability and the validity of the instrument. Multivariate regression analysis was used to examine factors associated with team performance in PACE.
Cronbach's alphas ranging from 0.76 to 0.89 demonstrate good-to-high reliability for all domains of the team process and performance (effectiveness). Construct validity is demonstrated through the results of the regression analysis showing that leadership, communication, coordination, and conflict management are positive and significant (P <0.001) predictors of team cohesion and team effectiveness. The data also support the appropriateness of aggregating individual-level responses to the unit level. Perceived team effectiveness significantly (P <0.05) increases with: age of the respondents; longer length of the team's professional work experience; shorter duration of the team's PACE experience; more ethnically diverse composition of the team; greater ethnic concordance between team members and the participants; and greater perceived resource availability.
Several of the factors influencing team effectiveness in PACE are potentially modifiable and, therefore, could offer insights for improving team practice.
本研究的目的是测试一种用于评估长期护理环境中跨学科团队绩效的调查工具的信度和效度,并衡量老年全面护理计划(PACE)中的团队绩效。
分析基于26个PACE项目团队成员完成的1220份调查问卷。使用克朗巴哈系数、方差分析和回归模型来评估该工具 的信度和效度。多元回归分析用于检验与PACE团队绩效相关的因素。
克朗巴哈系数在0.76至0.89之间,表明团队流程和绩效(有效性)的所有领域都具有良好到高度的信度。回归分析结果证明了结构效度,表明领导能力、沟通、协调和冲突管理是团队凝聚力和团队有效性的积极且显著(P<0.001)的预测因素。数据还支持将个人层面的回答汇总到单位层面的合理性。感知到的团队有效性随着以下因素显著(P<0.05)提高:受访者的年龄;团队专业工作经验的时长;团队PACE经验的时长;团队种族构成更多样化;团队成员与参与者之间更高的种族一致性;以及更高感知到的资源可用性。
影响PACE团队有效性的几个因素可能是可改变的,因此可以为改进团队实践提供见解。