Department of Health Sciences Research, Mayo Clinic, 200 First St SW, Harwick Building, Rochester, MN, 55905, USA.
Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA.
Qual Life Res. 2020 Nov;29(11):3143-3154. doi: 10.1007/s11136-020-02546-x. Epub 2020 Jun 10.
The purpose of this study was to test the known-groups validity and responsiveness to change of the Patient Experience with Treatment and Self-management (PETS, vs. 2.0), a measure of treatment burden.
The PETS and other standard measures were mailed at baseline and 12-month follow-up to adults living with multiple chronic conditions in southeast Minnesota (USA). A sample of 365 people (mean age = 62.1 years) completed both surveys. Baseline, 12-month, and changes in PETS burden scores were examined. Clinical anchors used to test validity included number of diagnoses (2-4 vs. 5+), mental health diagnosis (yes/no), medication adherence and health literacy (suboptimal/optimal), and changes in self-efficacy, global physical, and global mental health (worsening/improving). Independent-samples t-tests were used to compare scores.
PETS scales showed good internal consistency (αs ≥ 0.80). There were few differences across number of diagnoses, but having a mental health diagnosis was associated with higher baseline PETS burden scores (Ps < .05). Suboptimal medication adherence and health literacy over time were associated with worse 12-month PETS burden scores (Ps < .05). Compared with improvements, declines over time in self-efficacy, global physical health, and global mental health were each associated with worsening change scores on PETS impact summary, medical expenses, and bother due to medication reliance and medication side effects (Ps < .05).
Among multi-morbid adults, the PETS demonstrated evidence of known-groups validity and responsiveness to change across both objective (e.g., mental health diagnoses) and subjective anchors (e.g., changes in self-efficacy, global physical, and global mental health).
本研究旨在检验治疗负担评估工具——患者治疗体验和自我管理量表(PETS,版本 2.0)的已知群组有效性和对变化的反应能力。
在明尼苏达州东南部(美国)患有多种慢性疾病的成年人中,通过邮件发送 PETS 量表和其他标准量表进行基线和 12 个月随访。365 名(平均年龄 62.1 岁)完成了两次调查的人被纳入样本。检验了基线、12 个月和 PETS 负担评分的变化。用于检验有效性的临床锚点包括诊断数量(2-4 个与 5 个以上)、心理健康诊断(是/否)、药物依从性和健康素养(欠佳/良好)以及自我效能、总体身体和总体心理健康的变化(恶化/改善)。使用独立样本 t 检验比较得分。
PETS 量表具有良好的内部一致性(α 值≥0.80)。诊断数量之间的差异不大,但存在心理健康诊断与较高的基线 PETS 负担评分相关(P<0.05)。药物依从性和健康素养欠佳随时间变化与较差的 12 个月 PETS 负担评分相关(P<0.05)。与改善相比,自我效能、总体身体健康和总体心理健康随时间下降与 PETS 影响摘要、医疗费用以及因药物依赖和药物副作用引起的烦恼的变化评分恶化相关(P<0.05)。
在患有多种疾病的成年人中,PETS 表现出已知群组有效性和对变化的反应能力的证据,包括客观(如心理健康诊断)和主观锚点(如自我效能、总体身体和总体心理健康的变化)。