Schmidt Silke, Thyen Ute, Chaplin John, Mueller-Godeffroy Esther
Department of Medical Psychology, Center of Psychosocial Medicine, University Hospital of Hamburg, Germany.
Ambul Pediatr. 2007 Sep-Oct;7(5):374-82. doi: 10.1016/j.ambp.2007.04.007.
The instrument Child Health Care-Satisfaction, Utilization and Needs (CHC-SUN) has been developed cross-culturally to evaluate pediatric health care services for children with special health care needs (CSHCN) from the proxy perspective of parents.
The children of the participating parents received treatment in pediatric specialty clinics in 7 European countries for asthma, cystic fibrosis, diabetes, epilepsy, cerebral palsy, rheumatoid arthritis, and atopic dermatitis. The instrument was developed through a process including literature review, expert consensus, and item generation through focus groups. The pilot instrument was extensively tested to assess psychometric properties, support item reduction, and evaluate clinical validity. The final field version was tested in a new sample of 795 parents in 7 countries.
Pilot testing and item reduction resulted in a practical 40-item instrument with 14 single items related to provision of services (module 1), and 26 items related to 6 scales on satisfaction with care (module 2), and 1 item on general satisfaction with care. Satisfaction with care scales showed very good psychometric properties, both initially and in the field version, with Cronbach's alpha ranging between .80 and .95 in the revised scales. Both modules discriminated well between functional status and diagnosis across countries.
A new instrument is available to measure provision of services and satisfaction with care for children with chronic conditions from the perspective of parents. Cross-cultural analysis reveals that the measure is useful in multinational studies evaluating health services against the background of different health systems.
“儿童保健——满意度、利用情况与需求”（CHC - SUN）工具已在跨文化背景下开发出来，用于从家长的代理视角评估有特殊医疗保健需求儿童（CSHCN）的儿科医疗服务。
参与研究的家长的孩子在7个欧洲国家的儿科专科诊所接受哮喘、囊性纤维化、糖尿病、癫痫、脑瘫、类风湿性关节炎和特应性皮炎的治疗。该工具通过文献综述、专家共识以及焦点小组生成条目等过程开发而成。对初步工具进行了广泛测试，以评估心理测量特性、支持条目删减并评估临床有效性。最终的现场版本在7个国家的795名家长的新样本中进行了测试。
初步测试和条目删减产生了一个实用的40条目工具，其中14个单项与服务提供相关（模块1），26个条目与护理满意度的6个量表相关（模块2），以及1个关于护理总体满意度的条目。护理满意度量表在初步版本和现场版本中均显示出非常好的心理测量特性，修订后的量表中克朗巴哈系数在0.80至0.95之间。两个模块在不同国家的功能状态和诊断之间都有很好的区分度。
有了一个新工具可从家长视角衡量慢性病患儿的服务提供情况和护理满意度。跨文化分析表明，该测量方法在不同卫生系统背景下评估卫生服务的跨国研究中很有用。
