在十个中低收入国家的研究、政策和实践之间架起桥梁：为医疗保健提供者编制问卷并进行测试。
Bridging the gaps among research, policy and practice in ten low- and middle-income countries: development and testing of questionnaire for health-care providers.
机构信息
Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada.
出版信息
Health Res Policy Syst. 2010 Jan 29;8(1):3. doi: 10.1186/1478-4505-8-3.
BACKGROUND
The reliability and validity of instruments used to survey health-care providers' views about and experiences with research evidence have seldom been examined.
METHODS
Country teams from ten low- and middle-income countries (China, Ghana, India, Iran, Kazakhstan, Laos, Mexico, Pakistan, Senegal and Tanzania) participated in the development, translation, pilot-testing and administration of a questionnaire designed to measure health-care providers' views and activities related to improving their clinical practice and their awareness of, access to and use of research evidence, as well as changes in their clinical practice that they attribute to particular sources of research evidence that they have used. We use internal consistency as a measure of the questionnaire's reliability and, whenever possible, we use explanatory factor analyses to assess the degree to which questions that pertain to a single domain actually address common themes. We assess the questionnaire's face validity and content validity and, to a lesser extent, we also explore its criterion validity.
RESULTS
The questionnaire has high internal consistency, with Cronbach's alphas between 0.7 and 0.9 for 16 of 20 domains and sub-domains (identified by factor analyses). Cronbach's alphas are greater than 0.9 for two domains, suggesting some item redundancy. Pre- and post-field work assessments indicate the questionnaire has good face validity and content validity. Our limited assessment of criterion validity shows weak but statistically significant associations between the general influence of research evidence among providers and more specific measures of providers' change in approach to preventing or treating a clinical condition.
CONCLUSION
Our analysis points to a number of strengths of the questionnaire--high internal consistency (reliability) and good face and content validity--but also to areas where it can be shortened without losing important conceptual domains.
背景
用于调查医疗保健提供者对研究证据的看法和经验的工具的可靠性和有效性很少得到检验。
方法
来自十个中低收入国家（中国、加纳、印度、伊朗、哈萨克斯坦、老挝、墨西哥、巴基斯坦、塞内加尔和坦桑尼亚）的国家团队参与了问卷的制定、翻译、试点测试和管理，该问卷旨在衡量医疗保健提供者改善临床实践的观点和活动，以及他们对研究证据的认识、获取和使用，以及他们归因于他们使用过的特定研究证据来源的临床实践变化。我们使用内部一致性作为问卷可靠性的衡量标准，只要有可能，我们就使用解释性因素分析来评估与单一领域相关的问题实际上是否涉及共同主题的程度。我们评估问卷的表面有效性和内容有效性，在较小程度上，我们还探索其标准有效性。
结果
问卷具有较高的内部一致性，20 个领域和子领域中的 16 个（通过因子分析确定）的 Cronbach's alpha 值在 0.7 到 0.9 之间。两个领域的 Cronbach's alpha 值大于 0.9，表明某些项目存在冗余。现场工作前后评估表明问卷具有良好的表面有效性和内容有效性。我们对标准有效性的有限评估表明，提供者之间研究证据的总体影响与提供者预防或治疗临床疾病方法变化的更具体措施之间存在微弱但具有统计学意义的关联。
结论
我们的分析指出了问卷的一些优势——高内部一致性（可靠性）和良好的表面和内容有效性——但也指出了可以在不失去重要概念领域的情况下缩短问卷的领域。
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