Ziabakhsh Shabnam, Albert Arianne, Houlihan Edwina
Evaluation Specialist, BC Women's Hospital + Health Centre, Vancouver, BC.
Biostatistician, Women's Health Research Institute, Vancouver, BC, Adjunct Associate Professor, University of British Columbia, Vancouver, BC.
Healthc Policy. 2019 Nov;15(2):100-114. doi: 10.12927/hcpol.2019.25968.
Recognition of the value of the patient perspective on services has led healthcare organizations to measure patient care experiences. A brief, generic and psychometrically sound scale to measure patient experiences in ambulatory/outpatient settings in Canada would be useful and is currently lacking. The purpose of this study was to develop and validate an English-language hospital-based ambulatory patient experience survey tool in a Canadian context. Based on a review of more than 20 instruments measuring experiences predominately in non-acute care settings, we initially selected 27 items to be included in the questionnaire, addressing quality dimensions of access, communication, continuity and coordination, shared decision making, emotional support, trust/confidence, privacy, patient-reported impact and physical environment. The survey instrument was subsequently tested among 1,219 ambulatory patients, and its psychometric properties were assessed. A final questionnaire was produced with 14 items and two emerging subscales: Patient-Provider Communication and Overall Quality of Experience, as determined by a factor analysis. The items within the scale showed high construct validity. Reliability was also excellent for the instrument. The applicability of this tool in supporting quality improvement initiatives is discussed.
认识到患者对服务看法的价值,促使医疗保健机构去衡量患者的护理体验。在加拿大,目前缺乏一种简短、通用且心理测量学上合理的量表来衡量门诊/非住院环境下的患者体验。本研究的目的是在加拿大背景下开发并验证一种基于医院的门诊患者体验英语调查工具。在对20多种主要用于测量非急性护理环境下体验的工具进行综述后,我们最初选择了27个项目纳入问卷,这些项目涉及就诊机会、沟通、连续性与协调性、共同决策、情感支持、信任/信心、隐私、患者报告的影响以及物理环境等质量维度。该调查问卷随后在1219名门诊患者中进行了测试,并对其心理测量特性进行了评估。通过因子分析确定,最终形成了一份包含14个项目和两个新出现子量表的问卷:医患沟通和总体体验质量。量表中的项目显示出较高的结构效度。该工具的信度也非常出色。本文还讨论了该工具在支持质量改进举措方面的适用性。