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患者在各类精神卫生保健中的体验:问卷编制、测量不变性及患者报告。

Patient experiences with care across various types of mental health care: Questionnaire development, measurement invariance, and patients' reports.

机构信息

Leuven Institute for Healthcare Policy, University of Leuven, Leuven, Belgium.

Flemish Patient Platform, Heverlee, Belgium.

出版信息

Int J Methods Psychiatr Res. 2018 Mar;27(1). doi: 10.1002/mpr.1592. Epub 2017 Oct 13.

Abstract

To describe the development, validation, and findings of a patient experience questionnaire across 7 types of residential and ambulatory mental health care services. Thirty-five items were hypothesized to cover information, participation, therapeutic relationship, personalized care, organization and collaboration, safety, patient rights, outcomes of care, and discharge preparation and after-care. Also included were 2 overall rating items (scoring and recommending the organization). This Dutch questionnaire was applied in 79 organizations in Belgium (N patients = 5,168). Exploratory structural equation modelling was conducted on a random split-half sample to examine dimensionality. Confirmatory factor analysis and multiple group confirmatory factor analyses were conducted on the holdout sample to confirm dimensionality and assess measurement invariance across type of service and patient characteristics. Multilevel logistic regression models linking subscale top box scores to overall rating items were used to assess criterion validity. The hypothesized dimensionality was partly confirmed, and configural and scalar invariance were demonstrated across types of organizations and patient characteristics. Subscale scores were significantly associated with overall ratings. Process evaluation showed that participating organizations strongly support continued use of this questionnaire. This validated patient experience questionnaire supports comparison across organizations from different types of services to improve the quality of mental health care.

摘要

描述了一种跨 7 种住院和门诊心理健康护理服务的患者体验问卷的开发、验证和结果。假设 35 个项目涵盖信息、参与、治疗关系、个性化护理、组织和协作、安全性、患者权利、护理结果以及出院准备和后续护理。还包括 2 个总体评分项目(对组织进行评分和推荐)。该荷兰问卷应用于比利时的 79 个组织(N 患者=5168)。对随机半分割样本进行探索性结构方程建模,以检验维度。对保留样本进行验证性因子分析和多组验证性因子分析,以确认维度,并评估服务类型和患者特征的测量不变性。使用多级逻辑回归模型将子量表最高分与总体评分项目联系起来,以评估效标效度。假设的维度得到了部分证实,并且在组织类型和患者特征方面表现出了配置和标度不变性。子量表得分与总体评分显著相关。过程评估表明,参与组织强烈支持继续使用该问卷。这个经过验证的患者体验问卷支持从不同服务类型的组织之间进行比较,以提高心理健康护理的质量。

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