Gomutbutra Patama, Aramrat Apinun, Sattapansri Worapoj, Chutima Siam, Tooprakai Dusida, Sakarinkul Pokin, Sangkhasilapin Yaowapa
Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
J Med Assoc Thai. 2012 Aug;95(8):1105-13.
The Assessment Chronic Illness Care (ACIC), developed in the United States, is a quality-improvement tool used to help organization evaluate the strengths and weaknesses of their delivery of care for chronic illness in six areas, community linkages, self-management support, decision support, delivery system design, information systems, and organization of care. These areas of care are influenced by the Chronic Care Model. The questionnaire scale ranges from 0 to 11.
Translate in Thai language and validate the ACIC as a practical tool to measure the quality of chronic illness care in Thailand.
In a cross-sectional study, the content validity was examined by public health experts. The original ACIC was translated into Thai with permission from The MacColl Institute for Healthcare Innovation at Group Health's Center for Health Studies. The translation process followed the World Health Organization (WHO) process of translation and adaptation of instruments, including forward translation, expert panel and synthesis of the translation, back translation, pre-testing, and cognitive interviewing. The pre-testing was done by distributing the questionnaire to a sample of 12 organizations with cognitive interviewing, followed by revision and finalization of the questionnaire. The reliability and validity of the translated version was then examined by distributing the questionnaire to 172 organizations (84 district hospitals and 88 community health center primary care units within the upper northern part of Thailand)focusing on care of cerebrovascular disease.
The response rate was approximately 70% or 120 organizations. The results from these organizations 'self-assessment showed that the Thai version of ACIC achieved good levels of reliability and validity, with the range of Cronbach's alpha coefficients being 0.846 to 0.972 in each aspect of ACIC. However ACIC inablility to detect statistical significant difference in score for each dimension though the self-management support and decision support are the two relatively low score rating.
The Thai translation of the ACIC can be used as an organization self-assessment instrument to evaluate the quality of chronic care in Thailand Further explanatory research of association between ACIC assessment and organization change as well as clinical outcomes is needed.
美国开发的慢性病护理评估（ACIC）是一种质量改进工具，用于帮助组织评估其在六个领域提供慢性病护理的优势和劣势，这六个领域分别是社区联系、自我管理支持、决策支持、服务提供系统设计、信息系统和护理组织。这些护理领域受慢性病护理模式的影响。问卷量表的范围是0到11分。
将ACIC翻译成泰语并验证其作为衡量泰国慢性病护理质量的实用工具。
在一项横断面研究中，由公共卫生专家检查内容效度。经健康研究中心集团健康部的麦科尔医疗创新研究所许可，将原始的ACIC翻译成泰语。翻译过程遵循世界卫生组织（WHO）对工具进行翻译和改编的流程，包括正向翻译、专家小组和翻译综合、反向翻译、预测试和认知访谈。预测试是通过向12个组织的样本分发问卷并进行认知访谈来完成的，随后对问卷进行修订和定稿。然后通过向172个组织（泰国北部上部的84家 district hospitals 和88个社区卫生中心基层医疗单位）分发问卷来检查翻译版本的信度和效度，这些组织主要关注脑血管疾病的护理。
回复率约为70%，即120个组织。这些组织的自我评估结果表明，泰语版的ACIC具有良好的信度和效度，ACIC各方面的Cronbach's alpha系数范围为0.846至0.972。然而，尽管自我管理支持和决策支持是得分相对较低的两个维度，但ACIC无法检测到每个维度得分的统计学显著差异。
ACIC的泰语翻译可以用作组织自我评估工具，以评估泰国慢性病护理的质量。需要对ACIC评估与组织变革以及临床结果之间的关联进行进一步的解释性研究。
