Garcia-Subirats Irene, Aller Marta Beatriz, Vargas Lorenzo Ingrid, Vázquez Navarrete María Luisa
Grupo de Investigación en Políticas de Salud y Servicios Sanitarios, Servicio de Estudios y Prospectivas en Políticas de Salud, Consorcio de Salud y Social de Cataluña, Barcelona, España; Programa de doctorado en Biomedicina, Departamento de Ciencias Experimentales y de la Salud, Universitat Pompeu Fabra, Barcelona, España.
Grupo de Investigación en Políticas de Salud y Servicios Sanitarios, Servicio de Estudios y Prospectivas en Políticas de Salud, Consorcio de Salud y Social de Cataluña, Barcelona, España.
Gac Sanit. 2015 Mar-Apr;29(2):88-96. doi: 10.1016/j.gaceta.2014.10.009. Epub 2014 Dec 3.
To adapt and to validate the scale of the questionnaire Continuity of Care between Care Levels (CCAENA(©)) in the context of the Colombian and Brazilian health systems.
The study consisted of two phases: 1) adaptation of the CCAENA(©) scale to the context of each country, which was tested by two pretests and a pilot test, and 2) validation by means of application of the scale in a population survey in Colombia and Brazil. The following psychometric properties were analyzed: construct validity (exploratory factor analysis), internal consistency (Cronbach's alpha and item-rest correlations), the multidimensionality of the scales (Spearman correlation coefficients), and known group validity (chi-square test).
Of the 21 items of the original scale, 14 were selected and reformulated based on a statement with response options of agreement to a question with frequency response options. Factor analysis showed that items could be grouped into three factors: continuity across healthcare levels, the patient-primary care provider relationship, and the patient-secondary care provider relationship. Cronbach's alpha indicated good internal consistency (>0.80 in all the scales). The correlation coefficients suggest that the three factors could be interpreted as separated scales (<0.70) and had adequate ability to differentiate between groups.
The adapted version of the CCAENA(©) shows adequate validity and reliability in both countries, maintaining a high equivalence with the original version. It is a useful and feasible tool to assess the continuity of care between healthcare levels from the users' perspective in both contexts.
在哥伦比亚和巴西卫生系统背景下，对“不同医疗级别间照护连续性问卷（CCAENA(©)）”量表进行改编和验证。
该研究包括两个阶段：1）将CCAENA(©)量表改编以适应每个国家的情况，通过两次预测试和一次试点测试进行检验；2）通过在哥伦比亚和巴西的一项人群调查中应用该量表进行验证。分析了以下心理测量学特性：结构效度（探索性因素分析）、内部一致性（克朗巴哈系数和项目与总分相关性）、量表的多维性（斯皮尔曼相关系数）以及已知组效度（卡方检验）。
原始量表的21个项目中，基于一个带有同意程度回答选项的陈述改编为一个带有频率回答选项的问题后，选取并重新制定了14个项目。因素分析表明，这些项目可分为三个因素：不同医疗级别间的连续性、患者与初级医疗服务提供者的关系以及患者与二级医疗服务提供者的关系。克朗巴哈系数表明内部一致性良好（所有量表均>0.80）。相关系数表明这三个因素可被解释为独立的量表（<0.70），且具有足够的区分不同组别的能力。
改编后的CCAENA(©)量表在两国均显示出足够的效度和信度，与原始版本保持高度等效性。它是从用户角度评估两国不同医疗级别间照护连续性的一个有用且可行的工具。
