一般实践工作联盟量表的适应和验证：定性回顾和横断面调查。
Adaption and validation of the Working Alliance Inventory for General Practice: qualitative review and cross-sectional surveys.
机构信息
Academic Unit of General Practice, Australian National University Medical School, The Australian National University, Garran, Australia.
Research School of Psychology, Australian National University Research School of Psychology, The Australian National University, Acton, Australia.
出版信息
Fam Pract. 2019 Jul 31;36(4):516-522. doi: 10.1093/fampra/cmy113.
BACKGROUND
Relational aspects of primary care are important, but we have no standard measure for assessment. The 'working alliance' incorporates elements of the therapeutic relationship, shared decision-making, goal setting and communication skills. The Working Alliance Inventory (short form) (WAI-SF) has been used in adult psychology, and a high score on the survey is associated with improved outcomes for clients.
OBJECTIVE
To adapt the WAI-SF for use between GPs and patients and to test its concurrent validity with measures of shared decision-making and the doctor-patient relationship and discriminant validity with measures of social desirability.
METHODS
Two rounds of online survey feedback from 55 GPs and 47 patients were used to adapt the WAI-SF-the WAI-GP. The tool was then completed by 142 patients in waiting rooms after seeing their GP and by 16 GPs at the end of their session. Concurrent validity with measures of shared decision-making and patient-doctor depth of relationship was determined using Spearman Rho correlations. Patients also completed two social desirability surveys, and discriminant validity with WAI-GP was assessed.
RESULTS
Following feedback, the survey was re-worded to remove phrases that were perceived as judgmental or irrelevant. The patient measure of the WAI-GP was strongly correlated with Dyadic OPTION (rho = 0.705, P = 0.0001) and Patient-Doctor Depth of Relationship scale (rho = 0.591, P = 0.0001) and not with measures of social desirability.
CONCLUSION
The psychometric properties of the WAI-GP support its use for measuring GP-patient alliance. Possibilities for use include assessing the influence of therapeutic alliance on the effectiveness of interventions.
背景
初级保健的关系方面很重要，但我们没有评估的标准方法。“工作联盟”包含治疗关系、共同决策、目标设定和沟通技巧的元素。工作联盟量表（短式）（WAI-SF）已在成人心理学中使用，调查得分高与客户的改善结果相关。
目的
改编 WAI-SF 以用于 GP 和患者之间，并测试其与共同决策和医患关系测量的同时效度以及与社会期望测量的判别效度。
方法
通过 55 名全科医生和 47 名患者的两轮在线调查反馈来改编 WAI-SF-WAI-GP。然后，在看到他们的 GP 后，142 名患者在候诊室填写了该工具，16 名 GP 在就诊结束时填写了该工具。使用 Spearman Rho 相关性来确定与共同决策和医患关系深度测量的同时效度。患者还完成了两份社会期望调查，并评估了与 WAI-GP 的判别效度。
结果
根据反馈，对调查进行了重新措辞，以删除被认为是判断性或不相关的短语。WAI-GP 的患者测量与二元 OPTION（rho = 0.705，P = 0.0001）和医患关系深度量表（rho = 0.591，P = 0.0001）呈强相关，与社会期望测量无关。
结论
WAI-GP 的心理测量特性支持其用于测量 GP-患者联盟。可能的用途包括评估治疗联盟对干预效果的影响。
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