Department of General Practice and Health Services Research, University of Zurich, University Hospital of Zurich, Switzerland.
J Eval Clin Pract. 2012 Feb;18(1):1-4. doi: 10.1111/j.1365-2753.2010.01511.x. Epub 2010 Aug 4.
In Switzerland, there is a dearth of information on the extent to which patients with chronic illnesses receive care congruent with the Chronic Care Model (CCM). To drive quality improvement programmes, it is necessary to have practical assessment tools in the country's own language to evaluate the delivery of CCM activities.
German translation and adaptation of the original Assessment of Chronic Illness Care (ACIC). We followed a sequential forward and backward translation approach. In a multidisciplinary committee review the original English version and the translations were compared, instructions and formats modified and cross-cultural equivalences verified. The second version was pre-tested and multidisciplinary group discussion led to the final version which aimed to create a comprehensive culturally adapted translation capturing the original idea of the items rather than a direct one to one translation.
Difficulties encountered during the translation process consisted in the difference of health care settings and health care organization in Switzerland and USA.The adapted German version was delivered to a managed care organization in the city of Zurich to test the initial use for diabetes care. The average ACIC subscale scores were: organization of the health care delivery system: mean (m) = 7.31 (SD = 0.79), community linkages: m = 3.78 (SD = 1.09), self-management support: m = 4.88 (SD = 1.21), decision support: m = 4.79 (SD = 1.16), delivery system design: m = 5.56 (SD = 1.28) and clinical information systems: m = 4.50 (SD = 2.69). Overall, the ACIC subscale scores were comparable with the scores of the original testing.
After cultural adaptations the German version of the ACIC is applicable as a tool to guide quality improvement in chronic illness care in German speaking countries in Europe.
在瑞士，关于慢性病患者接受与慢性照护模式（CCM）相符的照护的程度，相关信息十分匮乏。为了推动质量改进计划，瑞士需要使用本国语言的实用评估工具来评估 CCM 活动的实施情况。
对原始慢性病评估工具（ACIC）进行德语翻译和改编。我们采用了逐步向前和向后翻译的方法。在一个多学科委员会的审查中，对原始英文版本和翻译版本进行了比较，修改了说明和格式，并验证了跨文化等效性。第二版进行了预测试，多学科小组讨论产生了最终版本，旨在创建一个全面的、文化适应性强的翻译，而不是直接的一对一翻译，以捕捉项目的原始理念。
翻译过程中遇到的困难在于瑞士和美国的医疗保健环境和医疗保健组织的差异。改编的德语版本已提供给苏黎世市的一家管理式医疗组织，用于测试其在糖尿病护理方面的初步使用情况。ACIC 子量表的平均得分如下：医疗保健提供系统的组织：平均值（m）= 7.31（SD = 0.79），社区联系：m = 3.78（SD = 1.09），自我管理支持：m = 4.88（SD = 1.21），决策支持：m = 4.79（SD = 1.16），交付系统设计：m = 5.56（SD = 1.28），临床信息系统：m = 4.50（SD = 2.69）。总体而言，ACIC 子量表的得分与原始测试的得分相当。
经过文化适应性调整后，ACIC 的德语版本可作为指导欧洲德语国家慢性病护理质量改进的工具。
