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以患者为中心的 PD 护理:患者体验问卷的编制与验证。

Patient-centeredness in PD care: development and validation of a patient experience questionnaire.

机构信息

Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, The Netherlands.

出版信息

Parkinsonism Relat Disord. 2012 Nov;18(9):1011-6. doi: 10.1016/j.parkreldis.2012.05.017. Epub 2012 Jun 15.

Abstract

INTRODUCTION

Patient-centeredness is increasingly recognized as a crucial element of quality of care. A suitable instrument to assess the level of patient-centeredness for Parkinson's disease (PD) care is lacking. Here we describe the development and validation of the Patient-Centered Questionnaire for PD (PCQ-PD), and its initial application in a large patient sample.

METHODS

Based on the outcomes of eight focus groups we composed a questionnaire that measures patient-centeredness by assessing patients' care experiences. The questionnaire was sent to 1112 Dutch PD patients, and face-, content- and construct-validity and reliability were assessed. The level of patient-centeredness was determined by calculating scores for overall patient-centeredness [0-3], subscale experiences [0-3], item experience, item priority and quality improvement.

RESULTS

895 PD patients (net response 82.0%) completed the questionnaire. After the validation procedure, the PCQ-PD addressed 46 care aspects in six different subscales of patient-centeredness. The internal consistency of the instrument, expressed in Cronbach's α per subscale, ranged from 0.62 to 0.84. The overall patient-centeredness score was 1.69 (SD 0.45). 'Emotional support' (1.05, SD 0.90) and 'provision of tailored information' (1.18, SD 0.57) subscales received the lowest experience ratings. 'Access to medical records' obtained the highest item quality improvement score (5.44).

CONCLUSIONS

This study produced a valid instrument to measure patient-centeredness in PD care. Psychometric properties of the instrument were good. Application of the PCQ-PD revealed the level of patient-centeredness in the care for PD patients in The Netherlands. The main outcome was a compelling call for the provision of tailored information and emotional support.

摘要

简介

以患者为中心的理念越来越被认为是医疗质量的关键要素。目前缺乏评估帕金森病(PD)护理以患者为中心程度的合适工具。本研究旨在描述帕金森病患者以患者为中心问卷(PCQ-PD)的开发和验证过程,并初步将其应用于大型患者样本。

方法

基于 8 个焦点小组的结果,我们编写了一份问卷,通过评估患者的护理体验来衡量以患者为中心的程度。该问卷发送给 1112 名荷兰 PD 患者,评估其表面效度、内容效度、结构效度和信度。通过计算总体以患者为中心程度[0-3]、亚量表体验[0-3]、项目体验、项目优先级和质量改进的分数来确定以患者为中心的程度。

结果

895 名 PD 患者(实际应答率为 82.0%)完成了问卷。经过验证程序,PCQ-PD 共涉及 6 个以患者为中心的亚量表中的 46 个护理方面。该工具的内部一致性,用各亚量表的 Cronbach's α 表示,范围为 0.62 至 0.84。总体以患者为中心程度得分为 1.69(SD 0.45)。“情感支持”(1.05,SD 0.90)和“提供量身定制的信息”(1.18,SD 0.57)亚量表的体验评分最低。“获取医疗记录”获得了最高的项目质量改进评分(5.44)。

结论

本研究开发了一种用于测量 PD 护理中以患者为中心程度的有效工具。该工具的心理测量学性质良好。PCQ-PD 的应用揭示了荷兰 PD 患者护理中的以患者为中心程度。主要结果是迫切需要提供量身定制的信息和情感支持。

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