验证一种用于评估专业人员所感知的向智障人士提供以患者为中心护理情况的工具。
Validation of an instrument to assess the delivery of patient-centred care to people with intellectual disabilities as perceived by professionals.
作者信息
Cramm Jane Murray, Nieboer Anna Petra
机构信息
Institute of Health Policy & Management (iBMG), Erasmus University, Rotterdam, The Netherlands.
出版信息
BMC Health Serv Res. 2017 Jul 11;17(1):472. doi: 10.1186/s12913-017-2424-8.
BACKGROUND
Patient/Person Centred Care (PCC) has achieved widespread attention which resulted in the identification of eight dimensions of PCC: Respect for the patients' values, preferences and expressed needs; information and education; access to care; emotional support to relieve fear and anxiety; involvement of family and friends; continuity and secure transition between healthcare settings; physical comfort; coordination of care. An instrument to assess patient centeredness of care delivery according to these eight dimensions among professionals is however lacking. The main objective of this study is therefore to develop and validate an instrument to assess the eight PCC dimensions among professionals providing care to institutionalized People With Intellectual Disabilities (PWIDs).
METHODS
This cross-sectional survey study was conducted in a disability care centre in the region Twente in the Netherlands, the Twentse Zorgcentra. All professionals delivering care to institutionalized PWIDs (n = 1146) were invited to participate. An instrument was developed to assess the eight dimensions of PCC, which was tested among 464 professionals (response rate = 40%). We tested the instrument by means of structural equation modelling, and examined its validity and reliability.
RESULTS
Indices of the 35-item PCC version are satisfactory but showed that the model left room for improvement and shortening of the instrument (RMSEA >0.06 and CFI < 0.95). Confirmatory factor analyses revealed good indices of fit with the 24-item PCC-instrument among professionals. Internal consistency of the overall instrument was also good.
CONCLUSIONS
The psychometric properties of the 24-item PCC-instrument were satisfactory, rendering it a valid and reliable instrument for assessing the eight dimensions of PCC among professionals providing care to institutionalized PWIDs.
背景
以患者/个人为中心的护理（PCC）已受到广泛关注，由此确定了PCC的八个维度：尊重患者的价值观、偏好和表达的需求；信息与教育；获得护理；缓解恐惧和焦虑的情感支持；家人和朋友的参与；医疗环境之间的连续性和安全过渡；身体舒适；护理协调。然而，目前缺乏一种工具来根据这八个维度评估专业人员提供护理的以患者为中心程度。因此，本研究的主要目的是开发并验证一种工具，以评估为机构化智力残疾患者（PWIDs）提供护理的专业人员对PCC八个维度的表现。
方法
这项横断面调查研究在荷兰特温特地区的一家残疾护理中心——特温特护理中心进行。邀请了所有为机构化PWIDs提供护理的专业人员（n = 1146）参与。开发了一种工具来评估PCC的八个维度，并在464名专业人员中进行了测试（回复率 = 40%）。我们通过结构方程模型对该工具进行了测试，并检验了其有效性和可靠性。
结果
35项PCC版本的指标令人满意，但表明该模型仍有改进和缩短工具的空间（RMSEA > 0.06且CFI < 0.95）。验证性因素分析显示，24项PCC工具在专业人员中具有良好的拟合指标。整个工具的内部一致性也很好。
结论
24项PCC工具的心理测量特性令人满意，使其成为评估为机构化PWIDs提供护理的专业人员对PCC八个维度表现的有效且可靠的工具。
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