Angell Beth
School of Social Service Administration, University of Chicago, 969 E. 60th St., Chicago, IL 60637, USA.
J Behav Health Serv Res. 2006 Jan;33(1):53-72. doi: 10.1007/s11414-005-9000-4.
Mental health clinicians rely on a range of legal mandates and interpersonal strategies of encouragement and pressure to address nonadherence to treatment. This paper describes the development and testing of a scale to assess formal and informal strategies used by clinicians to encourage adherence to medication. The 16-item measure was administered to 271 clinicians and analyzed using Rasch measurement modeling. Subsequently, items were revised and readministered to a second sample of 44 clinicians in an urban mental health clinic. Rasch analysis of the items yielded a coherent and internally consistent unidimensional measure of strategies used to promote adherence that vary on a continuum of pressure or social control. Criterion-related validity was assessed by observing the association of the measure with clinician ratings of client adherence. The resulting measure may be employed in future studies to examine the ways in which clinician behavior relates to medication adherence and to consumer perceptions of treatment alliance, quality of care, and perceived coercion.
心理健康临床医生依靠一系列法律规定以及鼓励和施压的人际策略来解决患者不坚持治疗的问题。本文描述了一个量表的开发和测试过程，该量表用于评估临床医生为鼓励患者坚持服药所采用的正式和非正式策略。该包含16个条目的量表被施用于271名临床医生，并使用拉施测量模型进行分析。随后，对条目进行了修订，并在一家城市心理健康诊所对44名临床医生的第二个样本再次施测。对这些条目的拉施分析得出了一个连贯且内部一致的单维度量表，用于测量促进坚持治疗的策略，这些策略在压力或社会控制的连续体上有所不同。通过观察该量表与临床医生对患者坚持治疗情况的评分之间的关联来评估与标准相关的效度。所得出的量表可用于未来的研究，以检验临床医生行为与药物治疗依从性之间的关系，以及消费者对治疗联盟、护理质量和感知到的强制的看法。
