Social Policy Research Unit, Department of Social Policy and Social Work, University of York, York, UK.
Personal Social Services Research Unit, School of Health Sciences, University of Manchester, Manchester, UK.
Qual Life Res. 2018 Oct;27(10):2745-2756. doi: 10.1007/s11136-018-1917-1. Epub 2018 Jun 19.
Researchers investigating person-centredness in older people's long-term community care are hindered by the lack of appropriate measures. Studies have tended to rely on proxy indicators or generic instruments, risking invalid results. This new research aimed to develop and psychometrically test a person-centredness scale for use in older people's community services.
Questionnaire items were sourced from groups of older people and mapped to a conceptual framework of person-centredness. A postal questionnaire in 2015-2016 tested these items with older people supported by mental health and social care services in five areas of England. Dimensionality was assessed through exploratory factor analysis and a confirmatory bifactor model, with classical item analysis removing weak items. Test-retest analysis was undertaken through a repeated postal questionnaire 3 weeks after the first.
Three factors were identified, representing (i) interpersonal and (ii) organisational aspects of person-centred care; and (iii) negatively phrased items. Removing weaker items resulted in an 18-item scale. The bifactor analysis concluded the summary scale was 'essentially unidimensional'. The Person-centred community care inventory (PERCCI) had excellent reliability, with Intra-Class Correlation Coefficient of 0.886 [95% CI 0.818-0.929]. A priori hypotheses about associations with satisfaction metrics and support variables were broadly confirmed.
The PERCCI has promising measurement properties and can be recommended for use in research with older adults using community mental health and social care services. Future developments must identify how sensitive the instrument is in detecting changing service quality.
研究老年人长期社区护理中以人为主导的研究人员受到缺乏适当措施的阻碍。研究往往依赖于代理指标或通用工具，冒着结果无效的风险。这项新的研究旨在开发和心理测试一种用于老年人社区服务的以人为主导的量表。
问卷项目来自老年人群体，并映射到以人为主导的概念框架。2015-2016 年的一项邮寄问卷测试了这些项目，参与者是来自英格兰五个地区的心理健康和社会护理服务支持的老年人。通过探索性因素分析和验证性双因素模型评估维度，通过经典项目分析剔除较弱的项目。通过第一次邮寄问卷后 3 周的重复邮寄问卷进行测试-重测分析。
确定了三个因素，代表（i）人际和（ii）以人为主导的护理的组织方面；以及（iii）措辞相反的项目。剔除较弱的项目后，得到一个 18 项的量表。双因素分析得出结论，总结量表是“本质上单一维度的”。以人为主导的社区护理清单（PERCCI）具有极好的可靠性，内部一致性系数为 0.886[95%置信区间 0.818-0.929]。关于与满意度指标和支持变量关联的先验假设得到了广泛证实。
PERCCI 具有有前途的测量特性，可推荐用于研究使用社区心理健康和社会护理服务的老年人。未来的发展必须确定该仪器在检测服务质量变化方面的灵敏度如何。
