Sandsdalen Tuva, Grøndahl Vigdis Abrahamsen, Wilde-Larsson Bodil
Faculty of Social and Health Sciences, Department of Health and Nursing Sciences, Inland Norway University of Applied Sciences, Elverum, Norway.
Faculty of Health and Welfare Sciences, Østfold University College, Halden, Norway.
J Multidiscip Healthc. 2020 Jun 12;13:495-506. doi: 10.2147/JMDH.S246184. eCollection 2020.
Patients' views on quality are important to improve person-centered palliative care. There is a lack of short, validated instruments incorporating patients' perspectives of the multidisciplinary palliative care services. The aim of this study was to develop a short form of the instrument Quality from the Patient's Perspective for Palliative Care (QPP-PC) and to describe and compare patients' perceptions of the subjective importance (SI) of care aspects and their perceptions of care received (PR).
A cross-sectional study was conducted in Norway including 128 patients (67% response rate) in four palliative care contexts. The QPP-PC, based on a person-centered theoretical framework, incorporating the multidisciplinary palliative care, comprises 4 dimensions; medical-technical competence, physical-technical conditions, identity-oriented approach and sociocultural atmosphere, 12 factors (49 items) and 3 single items. The instrument measures SI and PR. Development of the short form of the QPP-PC was inspired by previously published methodological guidelines. Descriptive statistics, paired -tests, confirmatory factor analysis and Cronbach's α were used.
The short form of QPP-PC consists of 4 dimensions, 20 items and 4 single items. Psychometric evaluation showed a root-mean-square error of approximation (RMSEA) value of 0.109 (SI). Cronbach's α values ranged between 0.64 and 0.85 for most dimensions on SI scales. Scores on SI and PR scales were mostly high. Significantly higher scores for SI than PR were present for the identity-oriented approach dimension, especially on items about information.
RMSEA value was slightly above the recommended level. Cronbach's α was acceptable for most dimensions. The short form of QPP-PC shows promising results and may be used with caution as an indicator of person-centered patient-reported experience measures evaluating the multidisciplinary palliative care for patients in a late palliative phase. However, the short version of QPP-PC needs to be further validated using new samples of patients.
患者对医疗质量的看法对于改善以患者为中心的姑息治疗至关重要。目前缺乏简短且经过验证的工具来纳入患者对多学科姑息治疗服务的看法。本研究的目的是开发一种简短版的《姑息治疗患者视角的质量》(QPP - PC)工具,并描述和比较患者对护理方面主观重要性(SI)的看法以及他们对所接受护理的看法(PR)。
在挪威进行了一项横断面研究,纳入了四个姑息治疗环境中的128名患者(回复率67%)。基于以患者为中心的理论框架并纳入多学科姑息治疗的QPP - PC包括4个维度;医疗技术能力、物理技术条件、身份导向方法和社会文化氛围,12个因素(49个项目)以及3个单项。该工具测量SI和PR。QPP - PC简短版的开发受到先前发表的方法学指南的启发。使用了描述性统计、配对检验、验证性因素分析和克朗巴哈α系数。
QPP - PC简短版由4个维度、20个项目和4个单项组成。心理测量评估显示近似均方根误差(RMSEA)值为0.109(SI)。SI量表上大多数维度的克朗巴哈α系数值在0.64至0.85之间。SI和PR量表的得分大多较高。身份导向方法维度的SI得分显著高于PR得分,特别是在关于信息的项目上。
RMSEA值略高于推荐水平。大多数维度的克朗巴哈α系数是可接受的。QPP - PC简短版显示出有前景的结果,可谨慎用作以患者为中心的患者报告体验测量指标,用于评估晚期姑息阶段患者的多学科姑息治疗。然而,QPP - PC简短版需要使用新的患者样本进一步验证。