Department of Psychology and Neuroscience, Baylor University, Waco, USA.
Department of Psychology and Neuroscience, Baylor University, Waco, USA.
Patient Educ Couns. 2020 Feb;103(2):376-384. doi: 10.1016/j.pec.2019.09.028. Epub 2019 Oct 1.
The current objective is to validate the Medical Consultation Experience Questionnaire (MCEQ) and to examine distinctions between constructs of patient perceived alliance and experienced confusion in relation to key health outcomes.
A total of 857 participants were recruited online across two samples (adults with various medical conditions and with diabetes and/or hypertension specifically).
A confirmatory factor analysis demonstrated good fit and high item loadings for the theoretical bifactor model. Item response theory analyses showed very high individual item discrimination and good test information across a wide range of values. Confusion was uniquely and significantly more strongly related to psychological distress than was alliance; the same was true for alliance with positive affect. Both alliance and confusion significantly contributed to treatment motivation. Only confusion explained unique variance in control of HbA1C levels and blood pressure after controlling for alliance and other variables.
The MCEQ is a valid instrument for assessing distinct constructs of alliance and confusion. Future research should focus on the unique role of confusion for patient outcomes.
By using the MCEQ to assess patient alliance and confusion, it may be possible to detect and prioritize individual patient needs and improve patient outcomes.
本研究旨在验证医学咨询体验问卷（MCEQ），并考察患者感知联盟与体验困惑与关键健康结果之间的结构区别。
共招募了两个样本（患有各种疾病的成年人和患有糖尿病和/或高血压的成年人）的 857 名参与者进行在线研究。
验证性因子分析显示，理论双因素模型具有良好的拟合度和高项目负荷。项目反应理论分析表明，在广泛的数值范围内，个体项目的区分度非常高，测试信息良好。困惑与心理困扰的关系比联盟更为独特和显著；联盟与积极情绪的关系也是如此。联盟和困惑都显著促进了治疗动机。在控制联盟和其他变量后，只有困惑能解释 HbA1C 水平和血压控制的独特差异。
MCEQ 是评估联盟和困惑的不同结构的有效工具。未来的研究应集中于困惑对患者结果的独特作用。
通过使用 MCEQ 评估患者的联盟和困惑，可能能够发现和优先考虑患者的个体需求，从而改善患者的结局。
