Rosemann Thomas, Laux Gunter, Droesemeyer Sabine, Gensichen Jochen, Szecsenyi Joachim
Department of General Practice and Health Services Research, University of Heidelberg, Heidelberg, Germany.
J Eval Clin Pract. 2007 Oct;13(5):806-13. doi: 10.1111/j.1365-2753.2007.00786.x.
The chronic care model and the 5A approach have achieved widespread acceptance and reflect the core elements of patient-centred care in chronic diseases, including arthritis. Appropriate assessment tools are indispensable to assess whether provided care is in alignment with these evidence-based conceptual frameworks of care. The aim of this study was to examine the validity of a translated and culturally adapted version of the Patient Assessment of Chronic Illness Care (PACIC 5A) questionnaire among osteoarthritis (OA) patients.
Of 300 administered questionnaires, 236 (78.6%) were returned. Established statistical approaches were used in order to assess psychometric properties. Test-retest reliability was tested in 75 randomly selected patients who received the questionnaire a second time after 2 weeks. The EUROPEP questionnaire was used in order to address external validity.
Scale internal consistency was confirmed with values ranging from 0.52 to 0.97 for Pearson's r. Internal consistency reliability was satisfying: Cronbach's alpha was 0.78 or higher for all scales. Test-retest reliability (intraclass correlation coefficient) exceeded 0.77. Correlations with the EUROPEP, which is not organized according to a conceptual approach to care, were only strong in corresponding scales.
The PACIC 5A is a reliable and valid instrument to assess the congruency of care to the chronic care model of OA patients. Its use is encouraged in quality improvement projects but also in further research.
慢性病护理模式和5A方法已获得广泛认可，并反映了以患者为中心的慢性病护理（包括关节炎）的核心要素。合适的评估工具对于评估所提供的护理是否符合这些基于证据的护理概念框架必不可少。本研究的目的是检验经翻译和文化调适后的慢性病患者护理评估（PACIC 5A）问卷在骨关节炎（OA）患者中的有效性。
在发放的300份问卷中，回收了236份（78.6%）。采用既定的统计方法来评估心理测量特性。在75名随机选择的患者中测试重测信度，这些患者在2周后再次收到问卷。使用欧洲患者满意度调查问卷（EUROPEP）来评估外部效度。
Pearson相关系数r值范围为0.52至0.97，证实了量表的内部一致性。内部一致性信度令人满意：所有量表的Cronbach's alpha均为0.78或更高。重测信度（组内相关系数）超过0.77。与未按照护理概念方法组织的EUROPEP的相关性仅在相应量表中较强。
PACIC 5A是评估OA患者护理与慢性病护理模式一致性的可靠且有效的工具。鼓励在质量改进项目以及进一步的研究中使用该工具。
