患者报告的医疗保健年龄友好性测量初步验证。

Preliminary Validation of a Patient-Reported Measure of the Age-Friendliness of Health Care.

机构信息

College of Pharmacy, Idaho State University, Meridian, Idaho.

Research Institute, Saint Alphonsus Regional Medical Center, Boise, Idaho.

出版信息

J Am Geriatr Soc. 2021 Jan;69(1):180-184. doi: 10.1111/jgs.16881. Epub 2020 Oct 17.

DOI:10.1111/jgs.16881

PMID:33068026

Abstract

BACKGROUND/OBJECTIVE: To evaluate the validity and reliability of a patient-reported measure of the "age-friendliness" of health care.

DESIGN

Based on four essential domains of high-quality health care for older outpatients (Medications, Mobility, Mentation and "what Matters," i.e., the 4 M's), we drafted a five-item questionnaire for older outpatients to rate the age-friendliness of their health care. One question addressed each of the 4 M's; the fifth addressed the overall age-friendliness of their care. After feedback from healthcare professionals, quality improvement experts, and a patient-caregiver focus group, we revised the items to create the Age-Friendliness Questionnaire (AFQ). SETTING We tested the AFQ by appending it to two surveys.

PARTICIPANTS

Older outpatients in Idaho during July to October 2019: Survey 1, with 23 other items, was sent to 1,257 older patients who were medically complex; Survey 2, with 35 other items, was sent to 2,873 older patients who visited outpatient primary care providers (PCPs) during the specified time period.

MEASUREMENTS

Respondents rated their providers' performance using a 1 to 5 ("never" to "always") scale for each of the five items (possible AFQ scores = 5-25).

RESULTS

The response rates were 41.4% and 33.3%, respectively. In Survey 1, the mean AFQ score from patients who had received care from a geriatrics consult clinic was higher than that from patients who had received their care from PCPs (19.3 vs 15.6; P < .001), and AFQ scores correlated with other quality-of-care scores. In Survey 2, AFQ scores predicted respondents' likelihood of recommending their providers to others (P < .001). The AFQ exhibited high internal reliability (interitem correlations = .49-.77; Cronbach's α = .89).

CONCLUSION

The AFQ appears to be a valid and reliable measure of the age-friendliness of outpatient care for older patients, and it predicts the likelihood that they will recommend their providers to others.

摘要

背景/目的：评估一种患者报告的医疗保健“友好度”的有效性和可靠性。

设计

基于高质量老年门诊医疗的四个基本领域（药物、移动能力、思维能力和“重要的事情”，即 4M），我们为老年门诊患者起草了一个五项问卷，让他们评价自己医疗保健的友好度。一个问题涉及到 4M 的每一个；第五个问题涉及到他们护理的整体友好度。在医疗保健专业人员、质量改进专家和患者-护理人员焦点小组的反馈后，我们修改了这些项目以创建友好度问卷（AFQ）。

地点

2019 年 7 月至 10 月，爱达荷州的老年门诊患者：调查 1 附有 23 个其他项目，发送给了 1257 名病情复杂的老年患者；调查 2 附有 35 个其他项目，发送给了在指定时间内看门诊初级保健提供者（PCP）的 2873 名老年患者。

测量

受访者使用 1 到 5（从不到总是）的评分对五个项目中的每个项目（可能的 AFQ 分数为 5-25）对他们的提供者的表现进行评分。

结果

响应率分别为 41.4%和 33.3%。在调查 1 中，从老年病门诊诊所获得护理的患者的平均 AFQ 评分高于从 PCP 获得护理的患者（19.3 比 15.6；P<.001），并且 AFQ 评分与其他医疗质量评分相关。在调查 2 中，AFQ 评分预测了受访者向他人推荐他们的提供者的可能性（P<.001）。AFQ 表现出较高的内部可靠性（项目间相关性=0.49-0.77；克朗巴赫的α=0.89）。