Avedis Donabedian Research Institute, Autonomous University of Barcelona, Barcelona, Spain.
Health Promot Int. 2010 Jun;25(2):221-9. doi: 10.1093/heapro/daq013. Epub 2010 Feb 22.
Despite a strong tradition in the literature on the patient information, education and involvement, there are few practical tools available to support hospitals in implementing such strategies. Based on the WHO Health Promoting Hospitals and Health Services (HPH) Strategy, we developed a self-assessment tool for health promotion in hospitals. We describe the development process and validity testing of the tool in a convenience sample of 38 hospitals from eight countries. We computed an overall compliance score, assessed internal consistency and tested associations of self-reported compliance with hospital characteristics, such as accreditation status and being member of the HPH network. The mean compliance with the tool, which assigns a possible score from 0 to 136, was 71.8 (SD 25.0). Floor effects were observed for standards 4 and 5 only (10.5 and 15.8%, respectively), but not for the overall score. Cronbach's alpha for the five scales in the tool ranged from 0.77 to 0.88. Being accredited or being a member of the HPH network was significantly associated with higher overall compliance (score 86.9 versus 64.2, p = 0.012 and 79.3 versus 51.9, p = 0.003, respectively). We developed and established preliminary validity of a self-assessment tool for health promotion in hospitals. Based on assessment of basic psychometric properties, analysis of reliability and construct validity, the tool suggests robustness for self-assessment purposes; however, further research on its validity is strongly warranted if the tool is to be used for other purposes than self-assessment.
尽管在患者信息、教育和参与方面的文献中存在强大的传统，但很少有实用工具可供医院用来实施这些策略。基于世界卫生组织的健康促进医院和卫生服务（HPH）战略，我们为医院的健康促进开发了一个自我评估工具。我们在来自八个国家的 38 家医院的便利样本中描述了工具的开发过程和有效性测试。我们计算了总体合规分数，评估了内部一致性，并测试了自我报告的合规性与医院特征（如认证状态和 HPH 网络成员）之间的关联。该工具的得分为 0 到 136 分，平均合规分数为 71.8（SD 25.0）。仅在标准 4 和 5 观察到地板效应（分别为 10.5%和 15.8%），但总体得分没有观察到。工具中五个量表的克朗巴赫 α 值范围为 0.77 至 0.88。获得认证或成为 HPH 网络的成员与更高的总体合规性显著相关（得分分别为 86.9 与 64.2，p = 0.012 和 79.3 与 51.9，p = 0.003）。我们开发并初步确立了医院健康促进自我评估工具的有效性。基于对基本心理测量特性、可靠性和结构有效性的分析，该工具表明在自我评估方面具有稳健性；然而，如果该工具要用于自我评估以外的目的，则强烈需要进一步研究其有效性。
