Brauer Paula, Royall Dawna, Kaethler Anneli, Mayhew Alexandra, Israeloff-Smith Maya
Department of Family Relations and Applied Nutrition,University of Guelph,Guelph,ONCanada.
Prim Health Care Res Dev. 2018 Nov;19(6):542-552. doi: 10.1017/S1463423617000937. Epub 2018 Jan 15.
AimWe developed a self-report tool to assess patients' experiences with lifestyle services in team-based primary care and pilot tested the questionnaire as part of a lifestyle intervention study to reverse metabolic syndrome.
Older client satisfaction questionnaires have been generally inadequate for quality improvement purposes, as they have been focused mainly on interpersonal skills of providers and/or in the context of one disease. New approaches to assessing the patient experience of lifestyle programs in primary care are needed and could inform quality improvement efforts over time.
The first phase in developing the questionnaire involved a group-administered questionnaire distributed to 38 healthcare providers in five groups to prioritize variables to include in the survey. Concepts were taken from a previous review of available questionnaires assessing primary care services. The draft questionnaire was reviewed by 11 participants from a lifestyle program using think-aloud cognitive interviewing techniques. The modified self-administered questionnaire (paper and online versions) was then pilot tested with 164 recipients of a nutrition and physical activity intervention program.FindingsProviders ranked the top variables to include in the questionnaire as: 'trust,' 'general communication,' 'first-contact accessibility,' 'whole-person care,' and 'respectfulness.' After cognitive interviewing and revisions, 21 multiple choice and two open-ended questions were used for pilot testing. Pilot testing identified additional minor wording changes that were needed for clarity, a decreased number of questions for redundant concepts, and decreased options for ceiling effects, resulting in 20 multiple choice and one open-ended question.
The modified self-administered patient experience questionnaire to assess lifestyle services in primary care has undergone rigorous development. Further validation is needed. The assessment of patient experience of lifestyle programs can be used to supplement other data to assess the overall effectiveness of such programs.
目的
我们开发了一种自我报告工具，以评估患者在团队初级保健中接受生活方式服务的体验，并作为一项旨在逆转代谢综合征的生活方式干预研究的一部分，对该问卷进行了预试验。
以往的老年患者满意度调查问卷通常不足以用于质量改进，因为它们主要关注提供者的人际技能和/或单一疾病背景。需要新的方法来评估初级保健中生活方式项目的患者体验，并且随着时间的推移，这些方法可以为质量改进工作提供信息。
问卷开发的第一阶段包括向五组38名医疗保健提供者发放一份小组管理的问卷，以确定调查中应包含的变量的优先级。概念取自之前对评估初级保健服务的可用问卷的综述。来自一个生活方式项目的11名参与者使用出声思考认知访谈技术对问卷初稿进行了审查。然后，经过修改的自我管理问卷（纸质版和在线版）在164名营养和身体活动干预项目的接受者中进行了预试验。
提供者将问卷中应包含的最重要变量列为：“信任”、“一般沟通”、“首次接触的可及性”、“全人护理”和“尊重”。经过认知访谈和修订后，21个多项选择题和两个开放式问题用于预试验。预试验发现，为了清晰起见，还需要进行一些细微的措辞修改，减少冗余概念的问题数量，并减少天花板效应的选项，最终形成了20个多项选择题和一个开放式问题。
经过修改的用于评估初级保健中生活方式服务的自我管理患者体验问卷已经历了严格的开发过程。还需要进一步验证。对生活方式项目患者体验的评估可用于补充其他数据，以评估此类项目的整体有效性。
