School of Allied Health Sciences, Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia.
School of Nursing and Midwifery, Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia.
J Hum Nutr Diet. 2019 Aug;32(4):535-546. doi: 10.1111/jhn.12644. Epub 2019 Apr 10.
The lack of a valid instrument to measure patient-centred care (PCC) in dietetic practice makes it challenging to evaluate how patient-centred dietitians are. The present study aimed to develop and psychometrically test a dietitian-reported inventory to measure PCC in dietetic practice.
The inventory was compiled based on a literature review of existing validated scales that measured the dimensions of PCC. Next, the inventory was distributed as a cross-sectional survey to 180 Australian Accredited Practicing Dietitians who worked in primary care. Exploratory factor analysis was performed using principal factor analysis with Promax rotation. Cronbach's alpha (criteria ≥0.80), inter-item correlations and corrected item-total correlations (criteria 0.30-0.70) were computed to evaluate the internal consistency of each scale.
Five factors were extracted accounting for 56.9% of the variance. Most variables had strong loadings on only one factor. Factors were labelled as: shared decision-making; holistic and individualised care; patient-dietitian communication; knowing the patient; and caring patient-dietitian relationships. Cronbach's alpha was 0.94 for the total inventory and ranged from 0.73 to 0.91 for the individual factors. Inter-item correlations and corrected item-total correlations mostly fell in the desired range.
The present study offers a preliminary, conceptually grounded dietitian-reported inventory, which is the first instrument developed and tested to measure PCC in dietetic practice. These findings illustrate the underlying factor structure of the inventory and support the reliability of the scales. With further testing, this inventory may provide useful to clinicians and researchers working to better understand and improve dietetic practice.
缺乏有效的工具来衡量饮食实践中的以患者为中心的护理（PCC），这使得评估以患者为中心的营养师的工作变得具有挑战性。本研究旨在开发和心理测量一种营养师报告的清单，以衡量饮食实践中的 PCC。
该清单是根据对现有已验证的衡量 PCC 维度的量表的文献回顾编制的。接下来，该清单作为横断面调查分发给 180 名在初级保健中工作的澳大利亚认证执业营养师。使用 Promax 旋转的主因子分析进行探索性因子分析。计算每个量表的内部一致性的克朗巴赫的阿尔法（标准≥0.80）、项目间相关性和校正项目总分相关性（标准 0.30-0.70）。
提取了五个因子，占方差的 56.9%。大多数变量仅在一个因子上有很强的负荷。因子分别标记为：共同决策制定；整体和个体化护理；医患沟通；了解患者；和关怀医患关系。清单的克朗巴赫的阿尔法为 0.94，各因子的范围为 0.73 至 0.91。项目间相关性和校正项目总分相关性大多落在理想范围内。
本研究提供了一个初步的、基于概念的营养师报告清单，这是第一个开发和测试的用于衡量饮食实践中 PCC 的工具。这些发现说明了清单的潜在因素结构，并支持了量表的可靠性。随着进一步的测试，该清单可能为致力于更好地理解和改善饮食实践的临床医生和研究人员提供有用的信息。
