Kilpatrick Kelley, Tchouaket Éric, Paquette Lysane, Guillemette Claudel, Jabbour Mira, Desmeules François, Landry Véronique, Fernandez Nicolas
Susan E. French Chair in Nursing Research and Innovative Practice, Ingram School of Nursing, McGill University, Montréal, Canada.
Centre intégré universitaire de santé et de services sociaux de l'Est-de-l'Île-de-Montréal-Hôpital Maisonneuve-Rosemont (CIUSSS-EMTL), Montréal, Canada.
BMC Health Serv Res. 2019 Jan 6;19(1):9. doi: 10.1186/s12913-018-3808-0.
There is a lack of validated instruments examining dimensions of team functioning from the perspective of patients and families consistent with a conceptual framework. The study aimed to develop and assess the psychometric properties of the Patient-Perceptions of Team Effectiveness (PTE) questionnaire.
A cross-sectional survey was undertaken in three studies. Data were collected from May-October 2016 for Study 1, April 2018-ongoing for Study 2, and October 2016 to June 2017 for Study 3. Online and paper versions of the self-administered questionnaire were available in English and in French. The initial questionnaire included 41 items. Study 1 included 320 respondents. Reliability was assessed using Cronbach alpha. Face validity (n = 250) was assessed using a structured questionnaire. Content validity was examined using subject matter experts and Spearman's item-total correlations. Construct validity was examined using known group comparisons (i.e., clinical specialty, education, length of follow-up, reason of consultation). Content analysis was used for open-ended questions.
The questionnaire took 10 to 15 min to complete. Positive assessments were noted for instructions, formatting, font size and logical ordering of questions. In Study 1, reliability indices for the PTE-Overall, Team Processes and Outcomes subscales ranged from 0.72 to 0.84. Item-total correlations ranged from 0.551 to 0.794 (p < 0.001). Differences were noted between clinical specialties, education, length of follow-up, reason of consultation, low and high functioning teams. No differences were noted between English and French language respondents. Psychometric properties were re-assessed in Study 2 and 3 after unclear questions were reworked. Reliability indices for the subscales ranged from 0.76 to 0.94 and differences remained significant between low and high functioning teams.
The final 43-item instrument is easy to administer to patients and families. The studies provide evidence of validity to support the propositions in the conceptual framework. The patient-level measures can be aggregated to the team, organizational or system level. The information can be used to assess healthcare team functioning in acute and primary care and determine the role patients and families are playing in teams. Further testing is needed with patients and families who are hospitalized or receiving care from teams in rural areas.
缺乏经过验证的工具，从患者和家属的角度审视与概念框架一致的团队功能维度。本研究旨在开发并评估患者对团队有效性的认知（PTE）问卷的心理测量特性。
在三项研究中进行了横断面调查。研究1于2016年5月至10月收集数据，研究2于2018年4月至今收集数据，研究3于2016年10月至2017年6月收集数据。自填式问卷有在线版和纸质版，提供英文和法文版本。初始问卷包括41个项目。研究1包括320名受访者。使用克朗巴哈系数评估信度。使用结构化问卷评估表面效度（n = 250）。使用主题专家和斯皮尔曼项目 - 总分相关性检验内容效度。使用已知组比较（即临床专科、教育程度、随访时间、咨询原因）检验结构效度。对开放式问题使用内容分析法。
问卷完成时间为10至15分钟。对问卷的说明、格式、字体大小和问题的逻辑顺序给予了积极评价。在研究1中，PTE总体、团队过程和结果子量表的信度指数范围为0.72至0.84。项目 - 总分相关性范围为0.551至0.794（p < 0.001）。在临床专科、教育程度、随访时间、咨询原因、低功能和高功能团队之间存在差异。英语和法语受访者之间未发现差异。在对不清楚的问题进行修改后，在研究2和3中重新评估了心理测量特性。子量表的信度指数范围为0.76至0.94，低功能和高功能团队之间的差异仍然显著。
最终的43项工具易于向患者和家属发放。这些研究提供了效度证据，以支持概念框架中的命题。患者层面的测量结果可以汇总到团队、组织或系统层面。这些信息可用于评估急性和初级保健中的医疗团队功能，并确定患者和家属在团队中所起的作用。需要对住院患者以及接受农村地区团队护理的患者和家属进行进一步测试。
