Melbourne School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Victoria 3010, Australia; Royal Melbourne Hospital Academic Centre, Parkville, Victoria 3010, Australia.
Res Social Adm Pharm. 2014 Jan-Feb;10(1):204-16. doi: 10.1016/j.sapharm.2013.04.013. Epub 2013 Jun 2.
Determination of patients' ability to self-administer medications in the hospital has largely been determined using the subjective judgment of health professionals.
To examine the validity, reliability and utility of the Self-Administration of Medication (SAM) tool as an objective means to determine patients' ability to self-administer in a rehabilitation unit of a public teaching hospital in Melbourne, Australia.
To assess validity of the SAM tool, associations were examined between the total SAM tool score and of the patients' competence to self-administer from the perceptions of the tool administrator, patients and nurses. Validity also was determined from a principal component analysis. Pearson correlations were calculated for how SAM scores related to scores obtained from the Functional Independence Measure (FIM) and Barthel Score Index (BSI). To assess the SAM tool's reliability, a Cronbach's alpha coefficient was calculated. Utility of the SAM tool was evidenced by documenting its administration time.
One hundred patients participated in this study. The SAM tool had a Cronbach's alpha coefficient of 0.75 and took a mean time of 5.36 min to complete. The capability to self-medicate section of the SAM tool had strong correlations with the FIM (r = 0.485) and BSI (r = 0.472) data, respectively, and the total SAM tool had moderate and strong correlations with the nurses' (r = 0.315) and tool administrator's (r = 0.632) perceptions of patients' ability to self-administer, respectively. Bland-Altman and ROC curve analyses showed poor agreement between the total SAM tool score and the nurses' perceptions.
The SAM tool demonstrated acceptable overall internal consistency. It only requires a short time to be completed and is more objective than seeking out health professionals' perceptions. Additional research is needed to further validate this approach to determining patients' ability to self-medicate.
在医院中，确定患者自行用药的能力主要依赖于卫生专业人员的主观判断。
检验自我给药能力评估工具（SAM 工具）在澳大利亚墨尔本一所公立教学医院康复病房中作为一种客观手段来确定患者自我给药能力的有效性、可靠性和实用性。
为评估 SAM 工具的有效性，我们检查了工具管理员、患者和护士对患者自我给药能力的感知与 SAM 工具总分之间的关联。此外，我们还进行了主成分分析来确定有效性。我们计算了 SAM 评分与功能独立性测量（FIM）和巴氏量表指数（BSI）评分之间的皮尔逊相关系数，以评估 SAM 评分与患者自我给药能力的相关性。为评估 SAM 工具的可靠性，我们计算了克朗巴赫α系数。SAM 工具的实用性通过记录其管理时间来证明。
共有 100 名患者参与了这项研究。SAM 工具的克朗巴赫α系数为 0.75，完成平均用时 5.36 分钟。SAM 工具中自我给药能力部分与 FIM（r=0.485）和 BSI（r=0.472）数据具有较强相关性，而 SAM 工具的总分与护士（r=0.315）和工具管理员（r=0.632）对患者自我给药能力的感知具有中度和较强相关性。Bland-Altman 和 ROC 曲线分析显示，SAM 工具总分与护士感知之间的一致性较差。
SAM 工具整体内部一致性可接受。它只需要很短的时间完成，并且比寻求卫生专业人员的意见更客观。需要进一步研究来进一步验证这种确定患者自我给药能力的方法。
