Bowman Julia, Lannin Natasha, Cook Catherine, McCluskey Annie
School of Biomedical and Health Sciences, College of Health and Science, University of Western Sydney, Australia.
J Eval Clin Pract. 2009 Feb;15(1):76-84. doi: 10.1111/j.1365-2753.2008.00957.x.
If allied health professionals are to begin measuring outcomes routinely, a change in attitudes and behaviour is necessary. However, individuals need to be ready to change and often move through several stages before practice change is observed.
To develop and test the psychometric properties of a questionnaire that determines clinicians' readiness to measure outcomes.
A study of instrument development, validation and reliability. Ten expert allied health professionals were involved in content validity testing. A further 396 allied health professionals completed the questionnaire to establish content and construct validity, internal consistency and temporal reliability (or stability). Of these 396 allied health professionals, 70 participated in the temporal reliability assessment. Content validity was established using the Content Validity Index (CVI). Construct validity was determined using confirmatory factor analysis (CFA) and internal consistency was ascertained using Cronbach's alpha. Temporal reliability was confirmed using intraclass correlation coefficients (ICC 3,1).
A 30-item questionnaire was developed, reflecting the five stages of change from the Transtheoretical Model of Change, and commonly cited barriers to outcome measurement. Content validity was excellent (CVI = 0.96). Using CFA, a two-factor model provided best fit. Based on CFA results, four items were dropped resulting in a 26-item questionnaire (range 26-156). Internal consistency reliability was excellent (alpha = 0.94). Temporal (stability) reliability ICC (3,1) was very good (r = 0.86, P = 0.0001).
The final 26-item questionnaire takes 10 minutes to complete and 5 minutes to score. The Clinician Readiness for Measuring Outcomes Scale provides educators with useful information about clinician readiness and helps identify strategies for affecting behaviour change.
如果专职医疗人员要开始常规性地衡量治疗效果，态度和行为的改变是必要的。然而，个体需要做好改变的准备，并且在实践改变被观察到之前通常要经历几个阶段。
开发并测试一份用于确定临床医生衡量治疗效果准备程度的问卷的心理测量特性。
一项关于工具开发、验证和可靠性的研究。十名专职医疗专家参与了内容效度测试。另外396名专职医疗人员完成了问卷，以确立内容效度和结构效度、内部一致性以及时间可靠性（或稳定性）。在这396名专职医疗人员中，70人参与了时间可靠性评估。使用内容效度指数（CVI）确立内容效度。使用验证性因子分析（CFA）确定结构效度，并使用克朗巴赫α系数确定内部一致性。使用组内相关系数（ICC 3,1）确认时间可靠性。
开发了一份包含30个条目的问卷，反映了行为改变阶段理论模型中的五个改变阶段以及常见的治疗效果测量障碍。内容效度极佳（CVI = 0.96）。使用CFA，一个双因子模型拟合最佳为。基于CFA结果，去掉了四个条目，形成了一份包含26个条目的问卷（范围为26 - 156）。内部一致性可靠性极佳（α = 0.94）。时间（稳定性）可靠性ICC（3,1）非常好（r = 0.86，P = 0.0001）。
最终的26个条目问卷完成需要10分钟，评分需要5分钟。临床医生治疗效果测量准备程度量表为教育工作者提供了有关临床医生准备程度的有用信息，并有助于确定影响行为改变的策略。
