Gallagher Patricia, Ding Lin, Ham Hazen P, Schor Edward L, Hays Ron D, Cleary Paul D
Center for Survey Research, University of Massachusetts, Boston, Massachusetts, USA.
Pediatrics. 2009 Nov;124(5):1348-54. doi: 10.1542/peds.2009-0495. Epub 2009 Oct 12.
In 1995, the Agency for Health Care Policy and Research initiated the Consumer Assessments of Healthcare Providers and Systems (CAHPS) project to develop and evaluate survey protocols for collecting reliable and valid assessments of health care from consumers. CAHPS surveys are used throughout the United States for evaluating ambulatory and hospital care experiences, including a version for assessing pediatric ambulatory care; however, pediatric experts thought that the existing pediatric instruments did not adequately assess developmental and preventive care. The objective of this study was to develop and test an Ambulatory Pediatric CAHPS survey that focuses on clinicians and groups and includes measures of developmental and preventive care.
To develop the survey, we conducted 2 focus groups and conducted 9 cognitive interviews. We conducted a telephone pretest with 20 parents and coded potential problems with the interview (behavioral coding). We conducted a dual-language field test of the instrument with 670 parents who reported about their children's ambulatory care. We used data from that survey to assess the reliability and validity of the measures.
Questions about developmental monitoring and preventive care were developed and tested. Two scales that were based on those new questions had good internal consistency (coefficient alpha) and inter-physician reliability. A consortium of CAHPS investigators and federal sponsors have approved the resulting instrument as a national measure of pediatric care.
A new instrument for assessing ambulatory pediatric care by clinicians and groups that includes questions about developmental and preventive care is now available for use.
1995年，医疗保健政策与研究机构启动了医疗服务提供者及系统消费者评估（CAHPS）项目，以开发和评估用于收集消费者对医疗保健的可靠且有效的评估的调查方案。CAHPS调查在美国各地用于评估门诊和住院护理体验，包括一个用于评估儿科门诊护理的版本；然而，儿科专家认为现有的儿科工具不能充分评估发育和预防保健。本研究的目的是开发并测试一项针对门诊儿科的CAHPS调查，该调查聚焦于临床医生和群体，并纳入发育和预防保健的测量指标。
为了开发该调查，我们开展了2个焦点小组讨论，并进行了9次认知访谈。我们对20位家长进行了电话预测试，并对访谈中的潜在问题进行编码（行为编码）。我们对670位报告其子女门诊护理情况的家长进行了该工具的双语现场测试。我们使用该调查的数据来评估测量指标的信度和效度。
有关发育监测和预防保健的问题得以开发和测试。基于这些新问题的两个量表具有良好的内部一致性（α系数）和医生间信度。CAHPS调查的研究人员和联邦赞助商组成的联盟已批准该最终工具作为儿科护理的一项全国性测量指标。
现在有了一种新的工具，用于评估临床医生和群体对门诊儿科护理的情况，该工具包含有关发育和预防保健的问题。
