School of Medicine, University of Queensland, Herston Road, Herston, Brisbane QLD 4006, Australia.
BMC Health Serv Res. 2009 Dec 3;9:218. doi: 10.1186/1472-6963-9-218.
Relatively little research attention has been given to the development of standardised and psychometrically sound scales for measuring influences relevant to the utilisation of health services. This study aims to describe the development, validation and internal reliability of some existing and new scales to measure factors that are likely to influence utilisation of preventive care services provided by general practitioners in Australia.
Relevant domains of influence were first identified from a literature review and formative research. Items were then generated by using and adapting previously developed scales and published findings from these. The new items and scales were pre-tested and qualitative feedback was obtained from a convenience sample of citizens from the community and a panel of experts. Principal Components Analyses (PCA) and internal reliability testing (Cronbach's alpha) were then conducted for all of the newly adapted or developed scales utilising data collected from a self-administered mailed survey sent to a randomly selected population-based sample of 381 individuals (response rate 65.6 per cent).
The PCA identified five scales with acceptable levels of internal consistency were: (1) social support (ten items), alpha 0.86; (2) perceived interpersonal care (five items), alpha 0.87, (3) concerns about availability of health care and accessibility to health care (eight items), alpha 0.80, (4) value of good health (five items), alpha 0.79, and (5) attitudes towards health care (three items), alpha 0.75.
The five scales are suitable for further development and more widespread use in research aimed at understanding the determinants of preventive health services utilisation among adults in the general population.
相对较少的研究关注用于测量与卫生服务利用相关的影响因素的标准化和心理测量学上可靠的量表的开发。本研究旨在描述一些现有和新量表的开发、验证和内部可靠性，以测量可能影响澳大利亚全科医生提供的预防保健服务利用的因素。
首先从文献回顾和形成性研究中确定相关的影响领域。然后使用和改编先前开发的量表以及从这些量表中得出的已发表的研究结果来生成项目。对新的项目和量表进行了预测试，并从社区的便利样本和专家小组中获得了定性反馈。然后，利用从随机选择的基于人群的 381 名个体（响应率为 65.6%）的自我管理邮寄调查中收集的数据，对所有新改编或开发的量表进行主成分分析（PCA）和内部可靠性测试（Cronbach's alpha）。
PCA 确定了五个具有可接受的内部一致性水平的量表：（1）社会支持（十项），α 0.86；（2）感知人际关怀（五项），α 0.87，（3）对医疗保健的可用性和可及性的关注（八项），α 0.80，（4）健康价值（五项），α 0.79，以及（5）对医疗保健的态度（三项），α 0.75。
这五个量表适合进一步开发和更广泛地用于研究，以了解普通人群中成年人预防保健服务利用的决定因素。
