Rensen Ans, van Mol Margo M, Menheere Ilse, Nijkamp Marjan D, Verhoogt Ellen, Maris Bea, Manders Willeke, Vloet Lilian, Verharen Lisbeth
Department of Emergency and Critical care, Faculty of Health, Behavior and Society, HAN University of Applied Sciences, Postbox 6960, 6503, GL, Nijmegen, The Netherlands.
Department of Intensive Care, Erasmus MC, University Medical Center's, Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
BMC Health Serv Res. 2017 Jan 24;17(1):77. doi: 10.1186/s12913-016-1975-4.
The quality standards of the Dutch Society of Intensive Care require monitoring of the satisfaction of patient's relatives with respect to care. Currently, no suitable instrument is available in the Netherlands to measure this. This study describes the development and psychometric evaluation of the questionnaire-based Consumer Quality Index 'Relatives in Intensive Care Unit' (CQI 'R-ICU'). The CQI 'R-ICU' measures the perceived quality of care from the perspective of patients' relatives, and identifies aspects of care that need improvement.
The CQI 'R-ICU' was developed using a mixed method design. Items were based on quality of care aspects from earlier studies and from focus group interviews with patients' relatives. The time period for the data collection of the psychometric evaluation was from October 2011 until July 2012. Relatives of adult intensive care patients in one university hospital and five general hospitals in the Netherlands were approached to participate. Psychometric evaluation included item analysis, inter-item analysis, and factor analysis.
Twelve aspects were noted as being indicators of quality of care, and were subsequently selected for the questionnaire's vocabulary. The response rate of patients' relatives was 81% (n = 455). Quality of care was represented by two clusters, each showing a high reliability: 'Communication' (α = .80) and 'Participation' (α = .84). Relatives ranked the following aspects for quality of care as most important: no conflicting information, information from doctors and nurses is comprehensive, and health professionals take patients' relatives seriously. The least important care aspects were: need for contact with peers, nuisance, and contact with a spiritual counsellor. Aspects that needed the most urgent improvement (highest quality improvement scores) were: information about how relatives can contribute to the care of the patient, information about the use of meal-facilities in the hospital, and involvement in decision-making on the medical treatment of the patient.
The CQI 'R-ICU' evaluates quality of care from the perspective of relatives of intensive care patients and provides practical information for quality assurance and improvement programs. The development and psychometric evaluation of the CQI 'R-ICU' led to a draft questionnaire, sufficient to justify further research into the reliability, validity, and the discriminative power of the questionnaire.
荷兰重症监护学会的质量标准要求监测患者亲属对护理的满意度。目前，荷兰尚无合适的工具来测量这一指标。本研究描述了基于问卷的消费者质量指数“重症监护病房亲属”（CQI“R-ICU”）的开发及心理测量学评估。CQI“R-ICU”从患者亲属的角度衡量感知到的护理质量，并确定需要改进的护理方面。
CQI“R-ICU”采用混合方法设计进行开发。项目基于早期研究以及对患者亲属的焦点小组访谈中涉及的护理质量方面。心理测量学评估的数据收集时间段为2011年10月至2012年7月。研究邀请了荷兰一家大学医院和五家综合医院的成年重症监护患者的亲属参与。心理测量学评估包括项目分析、项目间分析和因子分析。
十二个方面被确定为护理质量指标，随后被选入问卷内容。患者亲属的回复率为81%（n = 455）。护理质量由两个聚类表示，每个聚类都具有较高的信度：“沟通”（α = 0.80）和“参与”（α = 0.84）。亲属将以下护理质量方面列为最重要的：无相互矛盾的信息、医生和护士提供的信息全面、医护人员认真对待患者亲属。最不重要的护理方面是：与同龄人接触的需求、麻烦以及与精神顾问的接触。最急需改进（质量改进得分最高）的方面是：关于亲属如何为患者护理做出贡献的信息、关于医院餐饮设施使用的信息以及参与患者医疗决策。
CQI“R-ICU”从重症监护患者亲属的角度评估护理质量，并为质量保证和改进计划提供实用信息。CQI“R-ICU”的开发和心理测量学评估产生了一份问卷草案，足以证明有必要进一步研究该问卷的信度、效度和区分能力。
