Lenhard Fabian, Mitsell Kajsa, Jolstedt Maral, Vigerland Sarah, Wahlund Tove, Nord Martina, Bjureberg Johan, Sahlin Hanna, Andrén Per, Aspvall Kristina, Melin Karin, Mataix-Cols David, Serlachius Eva, Högström Jens
Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden.
Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden.
J Med Internet Res. 2019 Oct 1;21(10):e13602. doi: 10.2196/13602.
Patient adherence is defined as the extent to which a patient complies with medical or health advice. At present, there is a lack of reliable and valid measures specifically designed to measure adherence to internet-delivered behavioral interventions.
The objective of this study was to develop and psychometrically evaluate a novel measure of adherence to guided internet-delivered behavioral interventions.
In collaboration with experienced clinicians and researchers in the field, a 5-item, clinician-rated internet intervention Patient Adherence Scale (iiPAS) was developed. The initial scale was tested in a sample of children and adolescents (N=50) participating in internet-delivered cognitive behavioral therapy (ICBT) studies. A revised version of the iiPAS was then administered to a larger sample of children and adolescents (N=148) with various behavioral problems participating in ICBT trials. The scale was evaluated according to a classical test theory framework.
The iiPAS demonstrated excellent internal consistency. Factor analyses revealed one underlying factor, explaining about 80% of the variance, suggesting that the scale captures a homogeneous adherence construct. The iiPAS was strongly associated with objective measures of patient activity in ICBT (number of logins, number of written characters, and completed modules). Furthermore, mid- and posttreatment ratings of the iiPAS were significantly correlated with treatment outcomes. By contrast, objective measures of patient activity in the Web-based platform did not correlate with treatment outcomes.
The iiPAS could be a useful tool to measure adherence in a broad range of internet-delivered behavioral interventions.
患者依从性被定义为患者遵守医学或健康建议的程度。目前，缺乏专门设计用于测量对互联网行为干预依从性的可靠且有效的方法。
本研究的目的是开发并从心理测量学角度评估一种用于测量对指导性互联网行为干预依从性的新方法。
与该领域经验丰富的临床医生和研究人员合作，开发了一个由临床医生评分的包含5个条目的互联网干预患者依从性量表（iiPAS）。最初的量表在参与互联网认知行为疗法（ICBT）研究的儿童和青少年样本（N = 50）中进行了测试。然后，将iiPAS的修订版应用于参与ICBT试验的更大样本的有各种行为问题的儿童和青少年（N = 148）。该量表根据经典测试理论框架进行评估。
iiPAS表现出出色的内部一致性。因子分析揭示了一个潜在因子，解释了约80%的方差，表明该量表捕捉到了一个同质的依从性结构。iiPAS与ICBT中患者活动的客观测量指标（登录次数、书写字符数和完成的模块数）密切相关。此外，iiPAS在治疗中期和后期的评分与治疗结果显著相关。相比之下，基于网络平台的患者活动客观测量指标与治疗结果无关。
iiPAS可能是一种用于测量广泛的互联网行为干预中依从性的有用工具。
