Afshar Kambiz, Herbst Franziska A, Tetzlaff Fabian, Stiel Stephanie, Schneider Nils, Müller-Mundt Gabriele
Institut für Allgemeinmedizin, Medizinische Hochschule Hannover, Hannover, Deutschland.
Institut für Allgemeinmedizin, Medizinische Hochschule Hannover, Hannover, Deutschland.
Z Evid Fortbild Qual Gesundhwes. 2020 Aug;153-154:84-96. doi: 10.1016/j.zefq.2020.05.011. Epub 2020 Jul 19.
In Germany, no instruments exist to evaluate the practice and organisation of palliative care in general practice. The aim of this project was the systematic development and adjustment of a German version of the General Practice End of Life Care Index (GP-EoLC-I).
The translation and adaptation process followed the TRAPD model: translation, review, adjudication, pre-test, documentation. The process was completed by a back translation, a first pre-test and a feasibility study with general practitioners.
Nine of the ten general practitioners invited took part in the pre-test (56 % female, median age 55 years, range 40-75). The pre-test showed a median processing time of 15minutes. 17 general practitioners (59 % female, median age 53 years, range 39-69) took part in the pilot study. Adaptation to the German context was necessary for two of the 25 items. In the pre-test and in the pilot study only single values were missing. With the exception of the two adapted items, the back translation showed a high level of consistency with the original version of the questionnaire.
The systematic development and testing of the questionnaire "Hausärztliche Begleitung in der letzten Lebensphase" (HA-BeL) as well as its adaptation for the primary care setting in Germany was successfully completed in a multi-stage process using an interdisciplinary and participatory approach. The results of this empirical testing provide guidance for expenditure and reasonableness, objectivity of application and content-related consistency of the HA-BeL index.
The HA-BeL index is the first self-assessment instrument to be used by general practitioners to evaluate practice and organisation of palliative care in general practice in Germany.
在德国,目前尚无用于评估全科医疗中姑息治疗实践与组织情况的工具。本项目的目的是系统开发并调整德文版的全科医疗临终关怀指数(GP-EoLC-I)。
翻译与调整过程遵循TRAPD模型:翻译、审核、裁决、预测试、记录。该过程通过回译、首次预测试以及与全科医生进行的可行性研究得以完成。
受邀的10名全科医生中有9名参与了预测试(女性占56%,年龄中位数55岁,范围40 - 75岁)。预测试显示处理时间中位数为15分钟。17名全科医生(女性占59%,年龄中位数53岁,范围39 - 69岁)参与了试点研究。25个条目中有2条需要根据德国实际情况进行调整。在预测试和试点研究中,仅存在个别缺失值。除了两条调整后的条目外,回译与问卷原始版本显示出高度一致性。
通过跨学科和参与式方法,分多阶段成功完成了“临终阶段的全科医疗陪伴”(HA-BeL)问卷的系统开发与测试,以及针对德国初级医疗环境的调整。本次实证测试结果为HA-BeL指数的支出与合理性、应用的客观性以及内容相关性一致性提供了指导。
HA-BeL指数是德国全科医生用于评估全科医疗中姑息治疗实践与组织情况的首个自我评估工具。