Sjetne Ingeborg S, Iversen Hilde H, Kjøllesdal Johanne G
Norwegian Knowledge Centre for the Health Services, PO box 7004, St Olavs plass, N-0130, Oslo, Norway.
BMC Pregnancy Childbirth. 2015 Aug 21;15:182. doi: 10.1186/s12884-015-0611-3.
The Norwegian authorities monitor the quality of public health-care services, including from the patients' perspective. The aim of this paper is to describe the development and psychometric properties of a pregnancy- and maternity-care patients' experiences questionnaire (PreMaPEQ).
The PreMaPEQ and data collection procedures were developed based on a literature review, reference group activities, user interviews, cognitive interviews and a pilot test. The PreMaPEQ was then used in a national survey that included a retest distribution. The participants were identified from the hospital records where the birth took place. The invitation to take part was sent by mail and the questionnaire was distributed in electronic (i.e. via the Internet) and (subsequently) paper forms. The completed questionnaires were assessed using descriptive statistics, explorative factor analyses, psychometric measures and confirmatory factor analysis (CFA).
The PreMaPEQ response rate for the national sample was 56.6% (N = 4904), and retest data were provided by 123 women. Statistics and theoretical considerations were used to construct 16 scales, covering the following 4 phases of the care: pregnancy control (4 scales), the delivery (3 scales), the postnatal hospital stay (5 scales) and the services in the public health clinic (4 scales). All scales had a Cronbach's α of >0.7, and all but three scales had an intraclass correlation coefficient for test-retest stability of >0.700. CFA revealed a satisfactory fit between the questionnaire data and the model, with a four-factor solution of the care experiences with pregnancy, birth and postnatal care. CFA provided support for the suggested structures, and demonstrated that the first-order factors are indicators of a second-order factor.
The PreMaPEQ appears to be an acceptable, valid and reliable tool for collecting women's experiences of the whole course of maternity care in health systems that have features in common with the Norwegian health system.
挪威当局从患者角度监测公共卫生保健服务质量。本文旨在描述一份妊娠及产妇护理患者体验问卷（PreMaPEQ）的开发过程及心理测量特性。
PreMaPEQ及数据收集程序基于文献综述、参考小组活动、用户访谈、认知访谈和预测试开发而成。随后，PreMaPEQ被用于一项全国性调查，其中包括重测分发。参与者从分娩所在医院的记录中识别。参与邀请通过邮件发送，问卷以电子形式（即通过互联网）和（随后的）纸质形式分发。使用描述性统计、探索性因素分析、心理测量方法和验证性因素分析（CFA）对完成的问卷进行评估。
全国样本的PreMaPEQ回复率为56.6%（N = 4904），123名女性提供了重测数据。运用统计和理论考量构建了16个量表，涵盖护理的以下4个阶段：孕期检查（4个量表）、分娩（3个量表）、产后住院（5个量表）和公共卫生诊所服务（4个量表）。所有量表的Cronbach's α均>0.7，除三个量表外，所有量表的重测稳定性组内相关系数均>0.700。CFA显示问卷数据与模型之间拟合良好，采用了妊娠、分娩和产后护理体验的四因素解决方案。CFA为建议的结构提供了支持，并表明一阶因素是二阶因素的指标。
对于具有与挪威卫生系统共同特征的卫生系统而言，PreMaPEQ似乎是收集女性整个孕期护理体验的可接受、有效且可靠的工具。
