Holmboe Olaf, Iversen Hilde Hestad, Danielsen Kirsten, Bjertnaes Oyvind
Division of Health Services, Norwegian Institute of Public Health, Oslo, Norway.
BMJ Open. 2017 Oct 2;7(9):e016644. doi: 10.1136/bmjopen-2017-016644.
The aim of this study was to test the reliability and validity of a new questionnaire for measuring patient experiences with general practitioners (PEQ-GP) following a national survey.
Postal survey among patients on any of 500 GPs patient lists in Norway. GPs were stratified by practice size and geographical criteria.
4964 patients who had at least one consultation with their regular GP in the foregoing 12 months were included in the study. The patients were randomly selected after the selection of GPs. 2377 patients (49%) responded to the survey.
The items were assessed for missing data and ceiling effects. Factor structure was assessed using exploratory factor analyses. Reliability was tested with item-total correlation, Cronbach's alpha and test-retest correlations. Item discriminant validity was tested by correlating items with all scales. Construct validity was assessed through associations of scale scores with health status, the patients' general satisfaction with the services, whether the patient had been incorrectly treated by the GP and whether the patient would recommend the GP to others.
Item missing varied from 1.0% to 3.1%, while ceiling effects varied from 16.1% to 45.9%. The factor analyses identified three factors. Reliability statistics for scales based on these three factors, and two theoretically derived scales, showed item-total correlations ranging from 0.63 to 0.85 and Cronbach's alpha values from 0.77 to 0.93. Test-retest correlation for the five scales varied from 0.72 to 0.88. All scales had the expected association with other variables.
The PEQ-GP has good evidence for data quality, internal consistency and construct validity. The PEQ-GP is recommended for use in local, regional and national surveys in Norway, but further studies are needed to assess the instrument's ability to detect differences over time and between different GPs.
本研究旨在通过一项全国性调查，检验一份用于衡量患者对全科医生体验的新问卷（PEQ-GP）的信度和效度。
对挪威500名全科医生患者名单上的患者进行邮寄调查。全科医生按诊所规模和地理标准进行分层。
4964名在过去12个月里至少与他们的常规全科医生进行过一次咨询的患者被纳入研究。在选定全科医生后，患者被随机选取。2377名患者（49%）回复了调查。
对各项目进行缺失数据和天花板效应评估。使用探索性因素分析评估因素结构。通过项目总分相关性、克朗巴哈系数和重测相关性来测试信度。通过将各项目与所有量表进行相关性分析来测试项目区分效度。通过量表分数与健康状况、患者对服务的总体满意度、患者是否被全科医生错误治疗以及患者是否会向他人推荐该全科医生之间的关联来评估结构效度。
项目缺失率在1.0%至3.1%之间，而天花板效应在16.1%至45.9%之间。因素分析确定了三个因素。基于这三个因素以及两个理论推导量表的量表信度统计显示，项目总分相关性在0.63至0.85之间，克朗巴哈系数值在0.77至0.93之间。五个量表的重测相关性在0.72至0.88之间。所有量表与其他变量都有预期的关联。
PEQ-GP在数据质量、内部一致性和结构效度方面有充分的证据。建议在挪威的地方、区域和全国性调查中使用PEQ-GP，但需要进一步研究来评估该工具检测随时间变化以及不同全科医生之间差异的能力。
