Plochg Thomas, Arah Onyebuchi A, Botje Daan, Thompson Caroline A, Klazinga Niek S, Wagner Cordula, Mannion Russell, Lombarts Kiki
Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Meibergdreef 9, 1100 DE Amsterdam J2-211, The Netherlands;
Int J Qual Health Care. 2014 Apr;26 Suppl 1(Suppl 1):56-65. doi: 10.1093/intqhc/mzu014. Epub 2014 Mar 9.
Clinical management is hypothesized to be critical for hospital management and hospital performance. The aims of this study were to develop and validate professional involvement scales for measuring the level of clinical management by physicians and nurses in European hospitals.
Testing of validity and reliability of scales derived from a questionnaire of 21 items was developed on the basis of a previous study and expert opinion and administered in a cross-sectional seven-country research project 'Deepening our Understanding of Quality improvement in Europe' (DUQuE).
A sample of 3386 leading physicians and nurses working in 188 hospitals located in Czech Republic, France, Germany, Poland, Portugal, Spain and Turkey.
Validity and reliability of professional involvement scales and subscales.
Psychometric analysis yielded four subscales for leading physicians: (i) Administration and budgeting, (ii) Managing medical practice, (iii) Strategic management and (iv) Managing nursing practice. Only the first three factors applied well to the nurses. Cronbach's alpha for internal consistency ranged from 0.74 to 0.86 for the physicians, and from 0.61 to 0.81 for the nurses. Except for the 0.74 correlation between 'Administration and budgeting' and 'Managing medical practice' among physicians, all inter-scale correlations were <0.70 (range 0.43-0.61). Under testing for construct validity, the subscales were positively correlated with 'formal management roles' of physicians and nurses.
The professional involvement scales appear to yield reliable and valid data in European hospital settings, but the scale 'Managing medical practice' for nurses needs further exploration. The measurement instrument can be used for international research on clinical management.
假设临床管理对医院管理和医院绩效至关重要。本研究的目的是开发并验证专业参与量表，以衡量欧洲医院内科医生和护士的临床管理水平。
基于之前的研究和专家意见，对一份由21个项目组成的问卷所衍生的量表进行效度和信度测试，并在一项名为“深化我们对欧洲质量改进的理解”（DUQuE）的七国横断面研究项目中进行施测。
从捷克共和国、法国、德国、波兰、葡萄牙、西班牙和土耳其的188家医院中抽取了3386名主要内科医生和护士作为样本。
专业参与量表及子量表的效度和信度。
心理测量分析得出内科医生的四个子量表：（i）行政管理与预算编制，（ii）医疗实践管理，（iii）战略管理，（iv）护理实践管理。只有前三个因素适用于护士。内科医生内部一致性的Cronbach's α系数范围为0.74至0.86，护士为0.61至0.81。除内科医生中“行政管理与预算编制”与“医疗实践管理”之间的0.74相关性外，所有量表间相关性均<0.70（范围0.43 - 0.61）。在结构效度测试中，子量表与内科医生和护士的“正式管理角色”呈正相关。
专业参与量表在欧洲医院环境中似乎能产生可靠且有效的数据，但护士的“医疗实践管理”量表需要进一步探索。该测量工具可用于临床管理的国际研究。
