自主决定理论观察慢性病护理中的医疗保健专业人员的咨询：COUNSEL-CCE 工具的开发。
Self-Determination Theory to observe healthcare professionals' counselling in chronic care encounters: Development of the COUNSEL-CCE tool.
机构信息
University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium.
Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Belgium.
出版信息
Patient Educ Couns. 2021 Jul;104(7):1773-1780. doi: 10.1016/j.pec.2020.12.002. Epub 2020 Dec 9.
OBJECTIVE
To develop and psychometrically evaluate an observation tool to rate healthcare professionals' engagement in need-supportive and need-thwarting counselling in chronic care encounters.
METHODS
The observation tool was developed through three stages (January 2018 - June 2019). First, a set of items was developed according to essential components of need-supportive and need-thwarting counselling as identified in Self-Determination Theory. Second, content validation by five experts. Third, ecological validation using video-recorded real-life consultations. For the psychometric evaluation (June - October 2019), the tool was used by three observers to code 55 units of real-life encounters.
RESULTS
The Coding and Observing Need-Supportive Counselling in Chronic Care Encounters (COUNSEL-CCE) consists of 44 items clustered into nine theoretically underpinned behavioural approaches. Psychometric testing indicated acceptable to good consistency in scoring between observers and strong consistency within observers.
CONCLUSION
The COUNSEL-CCE captures person-oriented alongside process-oriented aspects during chronic care encounters. A person-oriented approach expresses counselling that is responsive to individual preferences and needs, whereas a process-oriented approach indicates the necessity to support competency building within patients, and is more instrumental of nature.
PRACTICE IMPLICATIONS
COUNSEL-CCE is a valuable observation tool to assess (graduate) healthcare professionals' counselling style and address if, and how, counselling evolves as a result of professional training.
目的
开发并对一种观察工具进行心理测量评估，以评估医疗保健专业人员在慢性病照护接触中进行支持需求和阻碍需求的咨询的情况。
方法
该观察工具通过三个阶段开发（2018 年 1 月至 2019 年 6 月）。首先，根据自我决定理论确定的支持需求和阻碍需求咨询的基本要素，制定了一组项目。其次，由五位专家进行内容验证。最后，使用视频记录的真实咨询进行生态验证。在心理测量评估（2019 年 6 月至 10 月）中，三位观察员使用该工具对 55 个真实咨询单元进行编码。
结果
《慢性病照护接触中编码和观察支持需求咨询的工具》（COUNSEL-CCE）包含 44 个项目，分为九个基于理论的行为方法。心理测量测试表明，观察者之间的评分一致性在可接受到良好之间，观察者内部的一致性很强。
结论
COUNSEL-CCE 在慢性病照护接触中同时捕捉到以患者为中心和以过程为导向的方面。以患者为中心的方法表示对个体偏好和需求做出响应的咨询，而以过程为导向的方法表示支持患者能力建设的必要性，并且更具有工具性。
实践意义
COUNSEL-CCE 是一种评估（研究生）医疗保健专业人员咨询风格的有价值的观察工具，并可以确定咨询是否以及如何因专业培训而发展。
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