验证以患者为中心的协同护理体验问卷（P3CEQ）。
Validation of the person-centred coordinated care experience questionnaire (P3CEQ).
机构信息
School of Psychology/Cognition institute, University of Plymouth, UK.
University of Plymouth Faculty of Medicine and Dentistry, John Bull Building, Plymouth Science Park, Research Way, Plymouth, UK.
出版信息
Int J Qual Health Care. 2019 Aug 1;31(7):506-512. doi: 10.1093/intqhc/mzy212.
BACKGROUND
Measuring patient experiences of healthcare is increasingly emphasized as a mechanism to measure, benchmark and drive quality improvement, clinical effectiveness and patient safety at both national and local NHS level. Person-centred coordinated care (P3C) is the conjunction of two constructs; person-centred care and care coordination. It is a complex intervention requiring support for changes to organizational structure and the behaviour of professionals and patients. P3C can be defined as: 'care and support that is guided by and organized effectively around the needs and preferences of individuals'. Despite the vast array of PRMS available, remarkably few tools have been designed that efficiently probe the core domains of P3C. This paper presents the psychometric properties of a newly developed PREM to evaluate P3C from a patient perspective.
METHODS
A customized EMIS search was conducted at 72 GP practices across the South West (Somerset, Devon and Cornwall) to identify 100 patients with 1 or more LTCs, and are frequent users of primary healthcare services. Partial Credit Rasch Modelling was conducted to identify dimensionality and internal consistency. Ecological validity and sensitivity to change were assessed as part of intervention designed to improve P3C in adults with multiple long-term conditions; comparisons were drawn between the P3CEQ and qualitative data.
RESULTS
Response rate for the P3CEQ was 32.82%. A two-factor model was identified. Rasch analysis confirmed unidimensionality of each factor (using infit MSQ values between 0.5 and 1.5). High internal consistency was established for both factors; For the Person-centred scale Cronbach's Alpha = 0.829, Person separation = 0.756 and for the coordination scale Cronbach's alpha = 0.783, person separation = 0.672.
CONCLUSIONS
The P3CEQ is a valid and reliable measure of P3C. The P3C is considered to have strong face, construct and ecological validity, with demonstrable sensitivity to change in a primary healthcare intervention.
背景
越来越强调衡量患者对医疗保健的体验，作为衡量、基准和推动国家和地方国民保健服务水平的质量改进、临床效果和患者安全的机制。以患者为中心的协调护理（P3C）是两个结构的结合；以患者为中心的护理和护理协调。这是一种复杂的干预措施，需要支持对组织结构以及专业人员和患者行为的改变。P3C 可以定义为：“以个人的需求和偏好为指导，并有效地围绕个人的需求和偏好组织的护理和支持”。尽管有大量的 PRMS 可用，但设计的工具很少能够有效地探测 P3C 的核心领域。本文介绍了一种新开发的 PREM 的心理测量特性，用于从患者角度评估 P3C。
方法
在英格兰西南部（萨默塞特、德文和康沃尔）的 72 家全科医生实践中进行了定制的 EMIS 搜索，以确定 100 名患有 1 种或多种慢性病且经常使用初级保健服务的患者。进行部分信用罗吉特建模以确定维度和内部一致性。作为旨在提高成年患者多种长期疾病患者 P3C 的干预措施的一部分，评估了生态有效性和对变化的敏感性；比较了 P3CEQ 和定性数据。
结果
P3CEQ 的回复率为 32.82%。确定了一个两因素模型。罗吉特分析证实了每个因素的单维性（使用 infit MSQ 值在 0.5 和 1.5 之间）。两个因素的内部一致性都很高；对于以人为中心的量表，克朗巴赫的阿尔法系数为 0.829，个体分离系数为 0.756，对于协调量表，克朗巴赫的阿尔法系数为 0.783，个体分离系数为 0.672。
结论
P3CEQ 是 P3C 的有效且可靠的测量工具。P3C 被认为具有很强的表面、结构和生态有效性，并在初级保健干预中表现出对变化的敏感性。
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