PatientsLikeMe, Boston, Massachusetts, United States of America.
School of Physical and Occupational Therapy, McGill University, Montreal, Canada.
PLoS One. 2019 Sep 5;14(9):e0220911. doi: 10.1371/journal.pone.0220911. eCollection 2019.
Patients and clinicians endorse the importance of compassionate healthcare but patients report gaps between its perceived importance and its demonstration. Empathy and compassion have been associated with quality of life and significant health outcomes but these characteristics are not optimally measured or used for performance and organizational improvement.
To address these gaps, we conducted a study with the objective of evaluating the properties of the 12-item Schwartz Center Compassionate Care Scale® using psychometric analysis and cognitive debriefing.
Non-hospitalized patients with multiple chronic conditions were sampled using an on-line platform. Classical test theory and Rasch measurement theory were used to evaluate psychometric properties of the scale. Structured questions elicited cognitive responses regarding clarity of each item.
Classical test theory analysis confirmed that the 12-item Schwartz Center Compassionate Care Scale is a unidimensional scale with excellent internal consistency and test-retest reliability. Patients' ratings of compassionate behaviors using the Schwartz Center Compassionate Care Scale correlated significantly with a related instrument designed to measure empathy, demonstrating convergent validity. Rasch measurement theory showed that reducing the number of response options on 3 items in the scale would improve respondents' discrimination between responses on these items. Although person-item threshold distribution analysis showed that patients may wish to rate compassionate care at levels both higher and lower than the scale permits, items could be ordered on an interval scale from low to high levels of compassionate care.
The current 12-item Schwartz Center Compassionate Care Scale demonstrates excellent psychometric properties by Classical Test Theory and Rasch measurement theory. The 12-item Schwartz Center Compassionate Care Scale adds questions related to understanding and discussing emotional, contextual issues and the needs of the patient and family. Easily completed on-line, it could be used for work-place based assessment and feedback to clinicians and performance or quality improvement.
患者和临床医生都认可富有同情心的医疗保健的重要性，但患者报告称，他们感受到的重要性与其实际表现之间存在差距。同理心和同情心与生活质量和重大健康结果有关，但这些特征并未得到最佳衡量或用于绩效和组织改进。
为了解决这些差距，我们进行了一项研究，旨在通过心理测量分析和认知剖析来评估 12 项 Schwartz 中心关爱护理量表的特性。
使用在线平台对患有多种慢性疾病的非住院患者进行抽样。经典测试理论和 Rasch 测量理论用于评估量表的心理测量特性。通过结构化问题，了解每个项目的清晰度。
经典测试理论分析证实，12 项 Schwartz 中心关爱护理量表是一个具有良好内部一致性和重测信度的单维量表。患者对 Schwartz 中心关爱护理量表中关爱行为的评分与旨在衡量同理心的相关工具显著相关，表明具有收敛效度。Rasch 测量理论表明，减少量表中 3 个项目的反应选项数量将提高受访者对这些项目的反应之间的区分度。虽然人员项目阈值分布分析表明，患者可能希望在比量表允许的更高和更低的水平上评价关爱护理，但可以根据从低到高的关爱护理水平对项目进行排序。
目前的 12 项 Schwartz 中心关爱护理量表通过经典测试理论和 Rasch 测量理论证明具有优异的心理测量特性。12 项 Schwartz 中心关爱护理量表增加了与理解和讨论情感、背景问题以及患者和家属需求相关的问题。该量表易于在线完成，可用于工作场所的评估和反馈给临床医生，以及绩效或质量改进。
