Department of Public Health, Center for Health Services and Nursing Research, University of Leuven, Kapucijnenvoer 35 4th Floor, Leuven B-3000, Belgium.
BMC Health Serv Res. 2013 Aug 19;13:325. doi: 10.1186/1472-6963-13-325.
Patient safety can be increased by improving the organization of care. A tool that evaluates the actual organization of care, as perceived by multidisciplinary teams, is the Care Process Self-Evaluation Tool (CPSET). CPSET was developed in 2007 and includes 29 items in five subscales: (a) patient-focused organization, (b) coordination of the care process, (c) collaboration with primary care, (d) communication with patients and family, and (e) follow-up of the care process. The goal of the present study was to further evaluate the psychometric properties of the CPSET at the team and hospital levels and to compile a cutoff score table.
The psychometric properties of the CPSET were assessed in a multicenter study in Belgium and the Netherlands. In total, 3139 team members from 114 hospitals participated. Psychometric properties were evaluated by using confirmatory factor analysis (CFA), Cronbach's alpha, interclass correlation coefficients (ICCs), Kruskall-Wallis test, and Mann-Whitney test. For the cutoff score table, percentiles were used. Demographic variables were also evaluated.
CFA showed a good model fit: a normed fit index of 0.93, a comparative fit index of 0.94, an adjusted goodness-of-fit index of 0.87, and a root mean square error of approximation of 0.06. Cronbach's alpha values were between 0.869 and 0.950. The team-level ICCs varied between 0.127 and 0.232 and were higher than those at the hospital level (0.071-0.151). Male team members scored significantly higher than females on 2 of the 5 subscales and on the overall CPSET. There were also significant differences among age groups. Medical doctors scored significantly higher on 4 of the 5 subscales and on the overall CPSET. Coordinators of care processes scored significantly lower on 2 of the 5 subscales and on the overall CPSET. Cutoff scores for all subscales and the overall CPSET were calculated.
The CPSET is a valid and reliable instrument for health care teams to measure the extent care processes are organized. The cutoff table permits teams to compare how they perceive the organization of their care process relative to other teams.
通过改善医疗服务的组织形式，可以提高患者的安全性。一种可以评估多学科团队对实际医疗服务组织情况感知的工具是护理过程自我评估工具（CPSET）。CPSET 于 2007 年开发，包含五个分量表的 29 个项目：（a）以患者为中心的组织；（b）护理过程的协调；（c）与初级保健的协作；（d）与患者和家属的沟通；（e）护理过程的随访。本研究的目的是进一步评估 CPSET 在团队和医院层面的心理测量学特性，并编制一个截断分数表。
在比利时和荷兰的多中心研究中评估了 CPSET 的心理测量学特性。共有 114 家医院的 3139 名团队成员参与了研究。通过验证性因子分析（CFA）、克朗巴赫α系数、组内相关系数（ICC）、克鲁斯卡尔-沃利斯检验和曼-惠特尼检验评估 CPSET 的心理测量学特性。使用百分位数编制截断分数表。同时还评估了人口统计学变量。
CFA 显示出良好的模型拟合度：标准化拟合指数为 0.93，比较拟合指数为 0.94，调整后的拟合优度指数为 0.87，均方根误差近似值为 0.06。克朗巴赫α值在 0.869 到 0.950 之间。团队层面的 ICC 值在 0.127 到 0.232 之间，高于医院层面的 ICC 值（0.071-0.151）。男性团队成员在 5 个分量表中的 2 个和 CPSET 的整体评分上的得分显著高于女性。不同年龄组之间也存在显著差异。医生在 5 个分量表中的 4 个和 CPSET 的整体评分上的得分显著高于其他人员。护理过程协调员在 5 个分量表中的 2 个和 CPSET 的整体评分上的得分显著低于其他人员。计算了所有分量表和 CPSET 的整体的截断分数。
CPSET 是一种有效的、可靠的工具，可用于评估医疗团队对护理过程组织程度的感知。通过使用截断分数表，团队可以将自身对护理过程组织的感知与其他团队进行比较。
