Medical Psychology and Medical Sociology, Medical Faculty, University of Freiburg, Hebelstr, 29, 79104 Freiburg, Germany.
BMC Health Serv Res. 2013 Oct 1;13:374. doi: 10.1186/1472-6963-13-374.
Effective patient-centred health care requires internal participation, which is defined as interprofessional patient-centred teamwork. Many scales are designed for measuring teamwork from the perspective of one type of health care professional (e.g. physician or nurse), rather than for the use for all health care professionals as well as patients. Hence, this paper's purpose is to develop a scale for measuring internal participation from all relevant perspectives and to check its psychometric properties.
In a multicentre cross-sectional study, a 6-item Internal Participation Scale (IPS) was developed and administered to 661 health care professionals (staff) and 1419 patients in 15 rehabilitation clinics to test item characteristics, acceptance, reliability (internal consistency) and construct validity. Additionally, we performed an exploratory factor analysis (EFA) to determine the factorial structure and explained variance. Confirmatory factor analysis (CFA) was used to verify the theoretically assumed one-dimensional factorial structure.
A total of 275 health care professionals and 662 patients participated, and the complete data sets of 272 staff members and 536 patients were included in the final analysis. The discrimination index was above .4 for all items in both samples. Internal consistency was very good, with Cronbach's alpha equalling .87 for the staff and .88 for the patient sample. EFA supported a one-dimensional structure of the instrument (explained variance: 61.1% (staff) and 62.3% (patients)). CFA verified the factorial structure, with the factor loadings exceeding .4 for five of six items in both samples. Global goodness-of-fit indices indicated a good model fit, with a Tucker-Lewis index (TLI) of .974 (staff) and .976 (patients) and a comparative fit index (CFI) of .988 (staff) and .989 (patients). The root mean square error of approximation (RMSEA) amounted to .068 for the patient sample and .069 for the staff sample. There is evidence of construct validity for both populations.
The analysis of the scale's psychometric properties resulted in good values. The scale is a promising instrument to assess internal participation from the perspective of both patients and staff. Further research should investigate the scale's psychometric properties in other interprofessional health care settings to examine its generalizability as well as its sensitivity to change.
有效的以患者为中心的医疗保健需要内部参与，内部参与被定义为跨专业以患者为中心的团队合作。许多量表是从一种医疗保健专业人员（如医生或护士）的角度设计的，用于衡量团队合作，而不是用于所有医疗保健专业人员以及患者。因此，本文的目的是开发一种从所有相关角度衡量内部参与的量表，并检查其心理测量特性。
在一项多中心横断面研究中，开发了一个包含 6 个条目的内部参与量表（IPS），并在 15 家康复诊所中对 661 名医疗保健专业人员（工作人员）和 1419 名患者进行了测试，以检验条目特征、可接受性、信度（内部一致性）和构念效度。此外，我们进行了探索性因素分析（EFA）以确定因子结构和解释方差。验证性因素分析（CFA）用于验证理论假设的一维因子结构。
共有 275 名医疗保健专业人员和 662 名患者参与，最终分析包括 272 名工作人员和 536 名患者的完整数据集。两个样本中所有条目的鉴别指数均高于.4。内部一致性非常好，工作人员的 Cronbach's alpha 为.87，患者样本为.88。EFA 支持该工具的一维结构（解释方差：工作人员为 61.1%，患者为 62.3%）。CFA 验证了因子结构，两个样本中六个条目的因子负荷均高于.4。总体拟合优度指数表明模型拟合良好，工作人员的 Tucker-Lewis 指数（TLI）为.974，患者为.976，比较拟合指数（CFI）为工作人员.988，患者为.989。患者样本的近似均方根误差（RMSEA）为.068，工作人员样本为.069。两个群体都有构念效度的证据。
对量表心理测量特性的分析得出了较好的结果。该量表是一种有前途的工具，可从患者和工作人员的角度评估内部参与。进一步的研究应在其他跨专业医疗保健环境中调查该量表的心理测量特性，以检验其普遍性以及对变化的敏感性。
