Department of Psychology, Royal Holloway, University of London, Surrey, TW20 0EX, UK.
Health Qual Life Outcomes. 2011 Sep 26;9:80. doi: 10.1186/1477-7525-9-80.
Intravenous steroids are routinely used to treat disabling relapses in multiple sclerosis (MS). Theoretically, the infusion could take place at home, rather than in hospital. Findings from other patient populations suggest that patients may find the experiences of home relapse management more desirable. However, formal comparison of these two settings, from the patients' point of view, was prevented by the lack of a clinical scale. We report the development of a rating scale to measure patient's experiences of relapse management that allowed this question to be answered confidently.
Scale development had three stages. First, in-depth interviews of 21 MS patients generated a conceptual model and pool of potential scale items. Second, these items were administered to 160 people with relapsing-remitting MS. Standard psychometric techniques were used to develop a scale. Third, the psychometric properties of the scale were evaluated in a randomised controlled trial of 138 patients whose relapses were managed either at home or hospital.
A preliminary conceptual model with eight dimensions, and a pool of 154 items was generated. From this we developed the MS Relapse Management Scale (MSRMS), a 42-item with four subscales: access to care (6 items), coordination of care (11 items), information (7 items), interpersonal care (18 items). The MSRMS subscales satisfied most psychometric criteria but had notable floor effects.
The MSRMS is a reliable and valid measure of patients' experiences of MS relapse management. The high floor effects suggest most respondents had positive care experiences. Results demonstrate that patients' experiences of relapse management can be measured, and that the MSRMS is a powerful tool for determining which services to develop, support and ultimately commission.
静脉注射类固醇通常用于治疗多发性硬化症（MS）的致残性复发。从理论上讲，输液可以在家中进行，而不是在医院进行。来自其他患者群体的研究结果表明，患者可能会发现家庭复发管理的体验更令人满意。然而，由于缺乏临床量表，从患者的角度来看，这两种情况的正式比较是不可能的。我们报告了一种衡量患者复发管理体验的评分量表的开发，该量表允许自信地回答这个问题。
量表开发分为三个阶段。首先，对 21 名 MS 患者进行深入访谈，生成了一个概念模型和潜在量表项目池。其次，将这些项目分发给 160 名复发缓解型 MS 患者。使用标准心理测量技术开发量表。第三，在一项对 138 名患者的随机对照试验中评估了该量表的心理测量特性，这些患者的复发在家中或医院管理。
生成了一个初步的概念模型，有八个维度，一个 154 项的项目池。由此我们开发了多发性硬化症复发管理量表（MSRMS），这是一个 42 项的量表，有四个子量表：护理途径（6 项）、护理协调（11 项）、信息（7 项）、人际护理（18 项）。MSRMS 子量表满足了大多数心理测量标准，但存在明显的地板效应。
MSRMS 是衡量患者多发性硬化症复发管理体验的可靠和有效的工具。高地板效应表明大多数受访者的护理体验是积极的。结果表明，患者的复发管理体验是可以衡量的，MSRMS 是确定应开发、支持和最终委托哪些服务的有力工具。
